严重胸外伤专科处理在院前急救中的应用研究.pdfVIP

320 中华灾害救援医学 2015 年6 月 第3 卷第6 期 Chinese Journal of Disas阳 Medicine. VoI. 3.No.6.June.2015 严重胸外伤专科处理在院前急救中的应用研究 邱忠进，储伟，张德海，王欢欢，曾万里，黄继江 【摘要] 目的探讨在院前急救中胸外伤专科处理的必要性。方法 收集江苏省徐州医学院第二附属医院 127 例严重 胸外伤或合并胸外伤患者，根据院前急救措施分成专科医师组(n =49) 和非专科医师组(n =78) ，观察两组患者的急救措施实 施及生命体征变化情况。结果 专科医师组49 例患者全部痊愈;非专科医师组痊愈73 例，死亡5 例。在处理严重气胸、连榈 胸方面，专科医师组与非专科医师组对比，差异有统计学意义(i =19.711 ,P 0. ∞1 旷= 11. 221 ,P =0. ∞8) ，而在处理非胸 外伤病情方面，差异无统计学意义(P=0.517)o 5 例死亡病例均有严重连棚胸损伤，急救现场及转运途中均未行有效的专科 处理。结论 胸外科专科医师与非专科医师处理气胸及连栅胸的意识及能力有明显差异，在院前急救中应提高胸外伤院前 急救意识，加强胸外科专科人员配置，为后期的创伤救治创造有利条件。 【关键词] 胸外伤;专科处理;院前急救 [中国图书分类号] 盯61 Study on the application of specialist treatment on severe thoracic trauma in prehospital emergency 。IU Zhongjin , CHU Wei , ZHANG Dehαi ， WANG Hua矶山n ， ZENG Wanli ， αnd HUANG Jijiang. Department of Thoracic Surge町， Second Affiliated Hospital of Xuzhou Medical College , X归hou 221006 , China Corresponding author;HUANG Jijiang , E-mail; h52 1I9628@163.com [ Abstract] 0时ective To investigate the necessity of specialist treatment for thoracic trauma in prehospital emergency Methods 127 severe thoracic trauma or combined with thoracic trauma patients were recruited in the Second Affiliated Hospital of XU7.hou Medical College and were divided into two groups (specialist group and non-specialist group) according to their prehospital e- m吨ency mmsues EA吨ency measures and vi时 signs changes in two groups of patients were observed. .ω叫ts 49ωes were all cured in specialist group; non-specialist group 73 cases were cured , 5 cases died. In the treatment of severe pneumotborax and flail chest , Lhere were significant statistical differencc between specialist group and non -specialist group (矿= 19. 711 , P 0. ∞1; X 2 = 1 1. 221 ， P=O. ∞剖， and no statistical significance in non-thoracic trauma treatment (P = O. 517). 5 death cases were severe flail chest i町ury; no effective