专职化院前急救对重型颅脑损伤患者预后影响.docVIP

专职化院前急救对重型颅脑损伤患者预后影响 　 作者：胡壮俐，邓艳华，姜伟，辜艳 【摘要】 目的 探讨专职化院前急救对重型颅脑损伤患者的预后影响。方法 回顾分析2003年1月～2006年12月51例重型颅脑损伤患者院前急救资料，29例行专职化院前急救患者为研究组，22例行非专职化院前急救患者为对照组，比较两组患者出车时间、到达现场时间及预后。结果 研究组院内反应时间及到达现场时间分别为（2.28±0.37）分和（10.07±1.27）分，较对照组明显缩短（Plt;0.05）；专职化院前急救预后良好率为58.62%，明显优于非专职化院前急救（Plt;0.05）；重度伤残及死亡率（41.38%）低于非专职化院前急救（Plt;0.05）。结论 专职化院前急救可明显提高重型颅脑损伤患者生存率与生存质量，降低死亡率与伤残率，改善患者预后。 【关键词】 颅脑损伤；创伤；院前急救 Abstract： Objective To investigate the effect of the professional prehospital emergency cares on prognosis of patients with severe traumatic brain injury(TBI).Methods The data of 51 severe TBI patients admitted between Jan.2003 and Dec.2006 were analyzed.Among 29 patients,who received professional prehospital emergency treatment were taken as study group,and 22 patients who received non professional prehospital emergency treatment were taken as control group.The vehicle dispatching time,arriving time and prognosis were compared between two groups.Results The average vehicle dispatching time and arriving time of study group was 2.28±0.37minutes and 10.07±1.27minutes respectively,which were significantly shorter than those of control group(Plt;0.05) .The rate of favorable prognosis in study group was 58.62%,which was significantly better than that in control group(Plt;0.05).Disability rate and mortality were lower compared with the control group(Plt;0.05).Conclusion The prehospital emergency care is the key for successful treatment of severe TBI patients and can improve the survival rate,quality of life and the outcome,decrease the disability rate and mortality. Key words:traumatic brain injury；trauma;prehospital emergency treatment 重型颅脑损伤患者伤情复杂，病情危重，病死率达30%～50%，如何提高救治成功率，降低伤残率及死亡率，已成为现代急救医学和创伤医学的难题之一，及时有效的院前急救对患者的预后常起到关键作用［1］。我院近年来通过成立专职院前急救队伍，重视重型颅脑损伤患者的院前急救，取得良好效果。 资料与方法 1 一般资料 研究组（2005年1月～2006年12月专职化院前急救组）29例，男性16例，女性13例；年龄1 ～81岁，平均（26.83±6.56）岁。格拉斯哥昏迷评分（GCS）≤5分15例，6～8分14例。致伤原因：道路交通伤17例，坠落伤8例，治安事件4例。对照组（2003年1月～2004年12月非专职化院前急救组）22例，男性13例，女性9例；年龄0.8～66岁，平均（26.45±6.73）岁。GCS≤5分1