现代网络院前急救模式对重型颅脑损伤预后影响

目的探讨现代网络院前急救模式对重型颅脑损伤患者预后的影响。方法将院前重型颅脑外伤患者分成两组；现代网络院前急救模式（A组，162例）由经过专业培训的急救队伍组成，能够进行基础、高级生命支持，配备先进急救设备和现代交通工具等，利用现代网络连接快捷的特点，在深圳市急救中心调度下开展院前现场急救工作；传统模式组（B组，124例）患者自行到达医院，无医务人员现场抢救及陪同。统计调度时间、到达时间、现场时间、返回时间、总时间，同时对受伤类型、颅内损伤程度、格拉斯哥预后分级（GOS）进行统计学分析。结果A组和B组的受伤类型、颅内损伤程度差异无显著性（P〉0．05）。A组预后伤残程度评级：良好72．22％，中残19．14％，重残1．85％，植物状态0．62％，死亡6．17％；B组预后伤残程度评级：良好47．58％，中残24．19％，重残12．10％，植物状态2．23％，死亡14．51％；A组预后优于B组，差异有显著性（P〈0．05）。结论现代网络院前急救模式能提升重型颅脑损伤急救速度，降低死亡率和改善预后。

Influence of modern network pre-hospital emergency care mode on the prognosis of severe brain trauma

Objective To explore the influence of modern network pre-hospital emergency care mode on the prognosis of the patients with severe brain trauma. Methods Divided the patients with severe brain trauma into 2 groups： modern network pre-hospital emergency care mode group（ A group, 162 cases ）, which had a professional rescue team that equipped with advanced first-aid equipment and had modern transportation and modern fast network, carried pre-hospital emergency rescue work out under the management of the Shenzhen City Emergency Center; Patients in traditional mode group （ B group, 124 cases ） went to hospital with no health care and no companionship of medical worker. Then recorded the scheduling time, running time, rescue time, returning time, and total time statistically analyzed the traumatic type, traumatic degree, and Glasgow Outcome Scale（ GOS） in both groups. Results There were no significant differences in traumatic type and traumatic degree between this both groups. The GOS outcomes of group A： V 72.22%, IV 19.14%, III 1.85%, 1I 0.62%, I 6.17% that was significantly better than group B＇s （ Ⅴ 47.58%, Ⅳ 24.19%, Ⅲ 12.10%,Ⅱ 2.23%, Ⅰ 14.51% P 〈 0.05 ）. Conclusions Modern network pre-hospital emergency care mode can speed up the rescue of patients with severe brain trauma, lower mortality, and improve prognosis.