Clinical analysis of treating severe and multiple trauma patients by trauma center using EICU as platform
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摘要: 目的通过以EICU为平台的创伤中心救治严重多发伤患者的临床效果分析，探讨提高严重多发伤预后的急救模式。方法采用回顾性病例对照研究分析211例严重多发伤患者的临床资料，其中2016年10月-2018年9月期间采用多学科会诊模式救治的103例严重多发伤患者作为对照组，2020年9月—2022年4月期间收治的108例采用以EICU为平台的创伤中心救治模式救治的严重多发伤患者作为研究组。观察比较两组的急诊救治时间、完成初次检查时间、抢救厅滞留时间、急诊手术时间以及两组患者的预后、两组合并重度颅脑损伤患者的预后。结果研究组急诊救治时间[(5.8±1.9) min]、完成初次检查时间[(31.3±12.2) min]、抢救厅滞留时间[(86±37) min]、急诊手术时间[(122±56) min]均明显短于对照组[(9.6±2.3) min]、[(52.7±14.6) min]、[(145±62) min]、[(182±78) min]，差异有统计学意义(P < 0.05)；研究组病死率明显低于对照组，差异有统计学意义(P < 0.05)；研究组合并颅脑损伤患者病死率明显低于对照组，差异有统计学意义(P < 0.05)。结论以EICU为平台的创伤中心救治模式能有效地缩短严重多发伤的救治时间，降低严重多发伤患者包括合并重度颅脑损伤患者的病死率，值得临床推广及进一步研究探索。Abstract: ObjectiveTo explore the first aid mode to improve the prognosis of severe multiple trauma by analyzing the clinical effects of trauma center using EICU as platform in treating severe multiple trauma patients.MethodsA retrospective case-control study was made to analyze the clinical data of 211 patients with severe multiple trauma within two years before and after September 2020. Among them, 103 before September 2020 who were treated by multidisciplinary consultation were taken as control group, and 108 after September 2020 who were treated in EICU-led trauma center were taken as study group. The time of emergency treatment, the time to complete the initial examination, the time of staying in the rescue hall, the time of emergency operation, the prognosis of the patients in the two groups, and the prognosis of the patients with severe craniocerebral injury in the two groups were observed and compared.ResultsThe time of emergency treatment[(5.8±1.9) min], the time to complete the initial examination[(31.3±12.2) min], the time of staying in the emergency room[(86±37) min], and the time of emergency operation[(122±56) min]in the study group were significantly shorter than those in the control group[(9.6±2.3) min]], [(52.7±14.6) min], [(145±62) min], [(182±78) min].The mortality rate of the study group was significantly lower than that of the control group(P < 0.05), and the mortality rate of the patients with craniocerebral injury in the study group was significantly lower than that of the control group(P < 0.05). P < 0.05).ConclusionThe trauma center using EICU as platform can effectively shorten the treatment time of severe multiple injuries and reduce the mortality of patients, especially of those with severe craniocerebral injury, which is worthy of promotion and further exploration.
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Key words:
- severe multiple trauma /
- multidisciplinary model /
- trauma center /
- prognosis
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表 1 两组严重多发伤患者一般资料比较
例(%)，X±S 组别 例数 性别 年龄/岁 致伤机制 ISS评分 男 女 交通伤 坠落伤 挤压伤、重物砸伤 研究组 108 77(71) 31(29) 16~83(46.6±14.87) 58(54) 32(30) 18(16) 27.2±10.2 对照组 103 79(77) 24(23) 12~82(45.7±14.23) 57(55) 29(28) 17(17) 26.7±9.8 χ2/t 0.728 0.410 0.069 0.731 P >0.05 >0.05 >0.05 >0.05 
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表 2 两组患者的急诊救治时间、完成初次检查时间、抢救厅滞留时间、急诊手术时间比较
min, X±S 组别 例数 急诊救治时间 完成初次检查时间 抢救厅滞留时间 急诊手术时间 研究组 108 5.8±1.9 31.3±12.2 86±37 122±56 对照组 103 9.6±2.3 52.7±14.6 145±62 182±78 χ2/t -12.273 -10.842 -7.781 -5.988 P < 0.01 < 0.01 < 0.01 < 0.01
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表 3 两组患者病死率(预后)比较
组别 存活 死亡 合计 病死率/% 研究组 97 11 108 10.2 对照组 77 26 103 25.2 χ2 6.966 P < 0.01
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表 4 两组合并重度颅脑损伤患者病死率比较
例 组别 存活 死亡 合计 病死率/% 研究组 39 14 53 26.4 对照组 22 21 43 48.8 χ2 3.994 P < 0.05
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