一体化急诊创伤外科运作模式初期实践的可行性分析

许臻晔; 黄梁; 史霆; 沈磊; 万歆; 陆一鸣

doi:10.13201/j.issn.1009-5918.2013.01.006

一体化急诊创伤外科运作模式初期实践的可行性分析

- 1. 上海交通大学医学院附属瑞金医院急诊科(上海,200025);
- 2. 上海交通大学医学院附属瑞金医院计算机中心

详细信息

通讯作者: 陆一鸣,E-mail:luyiming@rjh.com.cn

中图分类号: R641

收稿日期: 2012-12-04

Feasibility study in the initial practices of the integrated emergency trauma-surgery working model

- 1. Department of Emergency, Ruijin Hospital, Medical College of Shanghai Jiaotong University, Shanghai, 200025, China;
- 2. Computer Center of Ruijin Hospital, Medical College of Shanghai Jiaotong University

More Information

Corresponding author: LU Yiming, E-mail: luyiming@rjh.com.cn

Received Date: 04 December 2012

摘要

摘要: 目的:评价以普外科为基础的初期一体化急诊创伤外科运作模式在诊疗相关患者方面的效用和所收治患者的主要特点,并与以往分科共诊模式进行比较。方法:采集急诊创伤外科成立之前和之后各2年半收治入院的155名急诊外科创伤患者,对其伤情特点、收治效率、转归情况等方面进行比较。结果:所有收入院患者中以男性患者为主,平均年龄47.92岁,交通事故伤为致创首因,腹部、颅面部、前胸部为易伤部位。就诊和入院的高峰时间分布为8点至24点及12点至20点。创伤组手术患者入院前滞留时间(t=2.115,P<0.05)、入院至手术时间(t=2.381,P<0.05)、投诉纠纷事件(χ²=7.232,P<0.01)均短于或少于传统组。结论:以普外科为基础的初期一体化急诊创伤外科运作模式能够缩短患者入院或至急诊手术时间,提高伤员救治的及时性和连贯性,有利于减轻目前三级医院普遍较为严重的急诊患者的滞留问题及降低医疗投诉纠纷等隐患。可能对改善患者预后及缩短住院时间有所帮助,具有可行性。
- 急诊 /
- 创伤外科 /
- 一体化模式 /
- 创伤救治
Abstract: Objective:To analyze the effect of the initial integrated emergency trauma-surgery working model based on general surgery and patient's condition when compared with traditional model.Method:One hundred and fifty-five emergency trauma patients admitted to our hospital during 2 years before and after the foundation of emergency trauma surgery ward were selected,and the traumatic condition,treating efficiency and outcome were compared between the two groups.Result:There is a predominance of men in these patients whose average age is 47.92.Traffic accident is the main cause,and abdomen,craniofacial and front thoracic are predilection sites.The peak visit time is from 8 to 24 o'clock while the peak admission time is from 12 to 20 o'clock.The dwell time before admission(t=2.115,P<0.05),time cost during treatment(t=2.381,P<0.05) and complaint events(χ²=7.232,P<0.01) are shorter or less in trauma-surgery group than that of the control group.Conclusion:The initial integrated emergency trauma surgery working model based on general surgery is feasible to shorten the time cost during treatment and improve the consistency of rescue.This model is beneficial to relieve the overcrowding and reduce complaints.It is supposed to be helpful for improving prognosis and decreasing hospitalization duration.
- emergency /
- trauma-surgery /
- integrated model /
- emergency trauma care

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参考文献(17)

[1]	HENRY M C.The future of trauma care:at the cross-roads[J].J Trauma,2005,58:425-436.
[2]	STEVEN R S.The future of trauma surgery-aper-spective[J].J Trauma,2005,58:663-667.
[3]	沈伟锋,江观玉,干建新.创伤急救一体化的实践与探索[J].中华医院管理杂志,2006,22(2):114-117.
[4]	孙志扬,刘中民,唐伦先,等.一体化的创伤急诊模式在突发灾害事故急救中的优越性[J].中华急诊医学杂志,2005,14(7):549-551.
[5]	孙仲伦,王毅鑫,朱文献,等.综合性医院急救一体化运转模式探讨[J].中国急救医学,2007,27(10):954-956.
[6]	WILLEM F,WIM L,MULLIGAN T,et al.Patient demographics in acute care surgery at the Ruijin hos-pital in Shanghai[J].ISRN Surg,2011,2011:801404.
[7]	陈国庭,刘中民.急诊创伤外科的现状与未来[J].中华急诊医学杂志,2008,17(4):441-442.
[8]	SPAIN D A,RICHARDSON J D,CARRILO E H,et al.Should trauma surgeons do general surgery[J]?J Trauma,2000,48:433-438.
[9]	MICHAEL F,JAMES Y,NAOMI H.Injury in China:a systematic review of injury surveillance studies con-ducted in Chinese hospital emergency departments[J].BMC Emerg Med,2011,11:18-18.
[10]	孙志扬,刘中民,李侠.108例多发性创伤患者的救治体会[J].上海医学,2002,25(12):781-782.
[11]	汪勇,刘力克,张文慧.888例急诊创伤病例调查分析[J].现代预防医学,2001,28(1):57-59.
[12]	张连阳,姚元章,黄显凯.严重多发伤ICU期间的外科救治策略[J].中国急救复苏与灾害医学杂志,2010,5(8):703-706.
[13]	孙志扬,刘中民,李侠.108例多发性创伤患者的救治体会[J].上海医学,2002,25(12):781-782.
[14]	汪勇,刘力克,张文慧.888例急诊创伤病例调查分析[J].现代预防医学,2001,28(1):57-59.
[15]	何忠杰.医院急诊创伤救治的发展模式[A].第一届亚太急危重症学术大会论文汇编,2005,9:51-53.
[16]	KENNETH A,ANTHONY M,KEVIN F,et al.Mor-tality rates following trauma:The difference is night and day[J].J Emerg Trauma Shock,2011,4:178-183.
[17]	孙仲伦,王毅鑫,朱文献,等.综合性医院急救一体化运转模式探讨[J].中国急救医学,2007,27(10):954-956.