CAJ | 학술논문

目的探讨提高广东山区颅脑损伤救治成功率的救治模式. 方法通过实施新模式(2006年6月至2008年6月)两年间的住院前(拨打120后到医院办理住院手续前的时间)死亡率,住院死亡率,颅脑外科治疗前间期(伤后运送至颅脑专科诊疗时间)、急救半径(事故现场至可实施急救的医疗单位的距离)及心肺复苏成功率与旧模式(2004年6月至2006年5月1的数据进行比较分析. 结果旧模式下住院患者死亡率为29.06%(68/234).住院前患者死亡率为32.76%(114/348),分别高于新模式住院患者死亡率[10.49%(28/267)]、住院前患者死亡率[18.10%(59/326)],差异均有统计学意义(P<0.05).新模式的最大急救半径为10km、平均颅脑损伤治疗前间期为50min,均分别低于旧模式的最大急救半径(70 km)、平均颅脑损伤治疗前间期(85 min).新模式的心肺复苏成功率(80.32%)明显高于旧模式的(23.24%),差异有统计学意义(P<0.05).新模式的颅脑损伤治疗前间期≥1 h的患者死亡率[24.31%(35/144)]明显高于30-60 min[6.93%(7/101)]和<30 min[4.55%(1/22)的患者的死亡率,差异均有统计学意义(P<0.05). 结论山区利用120急救中心依托当地综合医院,增设服务网点,缩短急救半径及急救反应时间,加强医务人员尤其是基层网点工作人员颅脑专业院前急救技术,增强院前急救中心人员及出诊设备,可明显提高重型颅脑损伤救治的成功率.
목적 탐토제고엄동산구로뇌손상구치성공솔적구치모식. 방법 통과실시신모식(2006년6월지2008년6월)량년간적주원전(발타120후도의원판리주원수속전적시간)사망솔,주원사망솔,로뇌외과치료전간기(상후운송지로뇌전과진료시간)、급구반경(사고현장지가실시급구적의료단위적거리)급심폐복소성공솔여구모식(2004년6월지2006년5월1적수거진행비교분석. 결과 구모식하주원환자사망솔위29.06%(68/234).주원전환자사망솔위32.76%(114/348),분별고우신모식주원환자사망솔[10.49%(28/267)]、주원전환자사망솔[18.10%(59/326)],차이균유통계학의의(P<0.05).신모식적최대급구반경위10km、평균로뇌손상치료전간기위50min,균분별저우구모식적최대급구반경(70 km)、평균로뇌손상치료전간기(85 min).신모식적심폐복소성공솔(80.32%)명현고우구모식적(23.24%),차이유통계학의의(P<0.05).신모식적로뇌손상치료전간기≥1 h적환자사망솔[24.31%(35/144)]명현고우30-60 min[6.93%(7/101)]화<30 min[4.55%(1/22)적환자적사망솔,차이균유통계학의의(P<0.05). 결론 산구이용120급구중심의탁당지종합의원,증설복무망점,축단급구반경급급구반응시간,가강의무인원우기시기층망점공작인원로뇌전업원전급구기술,증강원전급구중심인원급출진설비,가명현제고중형로뇌손상구치적성공솔.
Objective To investigate the new way that can improve the emergency treatment rate on patients with traumatic brain injuries in Guangdong mountain area. Methods New emergency treatment way was adopted from June 2006 to June 2008 in patients traumatic brain injuries and these patients were chosen as experimental group. Control group is composed of patients treated with old emergency treatment way from June 2004 to June 2006. The pre-hospital mortality rate, in-hospital mortality rate and CPR success rate in the 2 groups were compared; the interphase between injury and receiving treatment, and the rescuing radius in these 2 groups were analyzed. Results Control grouphad the in-hospital mortality rate and pre-hospital mortality rate reaching 29.06% (68/234) and 32.76%(114/348), respectively, which was significantly higher than the experimental group (in-hospital mortality rate: 10.49% [28/267], pre-hospital mortality rate:18.10% [59/326]) (P<0.05). The maxima rescuing radius and mean interphase between injury and receiving treatment in the experimental group (10 km, 50min) were statistically different as compared with those in the control group (70 km, 85 min) (P<0.05).CPR success rate in the experimental group (80.32%) was obviously higher man that in the control group (23.24%) (P<0.05). The death rate in the experimental group was increased following the prolonged interphase between injury and receiving treatment. Conclusion The new way, by increasing 120urgent care centre, shortening the rescuing radius and reaction time, strengthening the care technique ofthe doctors and nurses and reinforcing the equipment in the urgent care centre, can obviously increase the emergency treatment rate.