规范创伤救治模式促进严重创伤救治质量的作用研究

目的 探讨规范创伤救治模式对严重创伤救治质量的促进作用. 方法 以2006年1月1日本院建立创伤中心为界,将新损伤严重度评分(NISS)≥16分的严重创伤患者分为研究组(创伤中心建立后2006 - 2008年)和对照组(创伤中心建立前2001-2005年),采用创伤数据库记录创伤患者伤情、救治与结局信息,比较严重创伤救治效率和质量的变化. 结果 研究组66例,对照组260例.研究组与对照组NISS值分别为(20.59±4.63)分和(20.57±5.38)分(P＞0.05)；研究组急诊处理时间为(0.33±0.03)h,对照组为(0.57±0.35)h (P ＜0.01)；研究组住院时间为(27.64±29.01)d,对照组为(30.84±32.87) d(P ＞0.05);研究组ICU治疗时间为(2.98±5.77)d,较对照组为(2.65±7.00) d(P ＞0.05)；研究组治愈率为87.9％,对照组为76.5％(P＜0.05)；研究组死亡率为9.1％,对照组为20.8％ (P ＜0.05). 结论 规范的创伤救治显著地提高了严重创伤的救治质量和水平.

Role of standard trauma system in improving care of severe trauma patients

Objective To study the positive influence of a standard trauma system on the care of severely injured patients.Methods The severely injured patients (NISS≥16 points)were divided into study group ( in 2006-2008,after the establishment of trauma center in our hospital) and control group (in 2001-2005,before the establishment of trauma center),which was bound by the establishment of the trauma center in our hospital in January 2006.The injury severity,care and outcomes were recorded by using China Trauma Database and changes in efficiency and quality of injury care were compared.Results The study group (66 patients) and control group (260 patients) with NISS of (20.59 ±4.63)points and (20.57 ± 5.38 ) points respectively,were similar in the distribution of severity ( P ＞ 0.05 ).The emergency care time was (0.33 ± 0.03) hour in the study group,which was significantly shortened compared with (0.57 ±0.35 ) hours in the control group (P ＜ 0.01 ).The length of hospital stay was (27.64 ±29.01 ) days in the study group,which was shorter than (30.84 ± 32.87 ) days in the control group (P ＞ 0.05 ),while the length of ICU stay was (2.98 ± 5.77 ) days in the study group,longer than (2.65 ± 7.00) days in the control group (P ＞ 0.05 ).The recovery rate was significantly increased from 76.5％ to 87.9％ (P ＜0.05) and mortality was significantly decreased from 20.8％ to 9.1％ (P ＜0.05).Conclusion The study indicates that the standard first aid model can notably improve the trauma care in our hospital.