摘要
目的比较三级转诊和一体化创伤救治模式与基层医院多专科分科救治模式在严重多发伤治疗的预后，探讨适合我国国情的创伤救治模式。方法2006年6月～2009年6月同济医院院外急救转运的120例基层医院严重多发伤病例（转诊组120例）。对照资料：转诊对口的县市级基层医院120例多发伤病例（基层组120例），及同济医院急救中心急诊外科门诊接诊的120例首诊多发伤病例（一手组120例）。比较两种治疗模式对严重多发伤患者的预后。创伤严重程度评分标准，按照AIS90创伤严重度评分（IsS）方法评分，（严重16≤Iss≤25）。结果在患者有关预后的指标方面（病死率、并发症发生率、延迟诊断及漏诊），一手组明显优于转诊组，转诊组又优于基层组。结论三级创伤分级转诊救治和一体化创伤救治模式在严重多发伤治疗的预后方面显著优于基层医院多专科分科救治，三级创伤分级转诊和一体化的专业创伤救治模式适合在全国多区域医疗中心推广。
Objective To compare the effects of three-level referral model combined with integration treatment model and the multidisciplinary faculty-based consultation model on the prognosis of severe multiple trauma. Methods 120 patients of severe multiple trauma with the injury severity score （ISS） between 16 and 25 were transferred to Tongji Hospital from different county-level hospitals in Hubei after treated there after the faculty-based treatment model or model of consultation of specialists, and then treated here after the model of integration of pre-hospital emergency treatment →emergeney operation→ ICU of traumatic surgery→rehabilitation （referral group）, 120 similar patients were treated directly in Tongji Hospital after the integration model （initial integration group）, and 120 similar patients were treated in the grass-roots hospitals after the facuhy-based treatment model or model of consultation of specialists （grass-roots group）. The effects of treatment were observed and compared. Results The initial integration group was superior to the referral group in the prognosis-related indicis [rates of traumatic shock, infection, acute inflammatory response syndrome, sepsis, electrolyte disorders, muhiple organ failure, and early mortality （〈3 days）, number of death, delayed and missed diagnosis], and the referral group was superior to the grass-roots group. Conclusion The three-level referral model and integration treatment model is superior to the muhidisciplinary faculty-based consultation model in the prognosis of severe multiple tramna and is worth popularizing.
出处
《中国急救复苏与灾害医学杂志》
2010年第9期801-804,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
多发伤
急救
三级转诊
一体化创伤救治
基层医院
Multiple trauma
Integration treatment model
Integration treatment model
