CAJ | 학술논문

目的通过对交通事故性重型颅脑损伤在院内急救期间各生命体征、意识、瞳孔及时间等环节上的变化,显示院内急救的重要性和一般规律,为我国相关部门制定急性颅脑创伤的预防和控制措施做出参考依据. 方法以南方医科大学珠江医院神经外科组织制定及71家医院专家委员会审定的《交通事故性重型颅脑损伤统计表》为依据收集自2008年4月1日至2009年3月30日因交通事故致重型颅脑损伤患者1107例的临床资料,根据在院内急救过程中患者意识状态、瞳孔变化、GCS评分、血压、呼吸、脉搏等指标在转入及转出急诊科间的变化,进行函数推算,分析判断病情发展趋势、抢救效果和下一步治疗措施. 结果根据院内急救时间显示在10～60 min内入急诊的患者最多,尤其在10～30 min占总就诊患者的38.9％.直观发现,患者经过院内急救有效治疗后,意识状态、瞳孔变化、GCS评分、血压、呼吸、脉搏等指标中表现差的患者例数逐渐减少,表现中等、较好和好的例数增多,在进入下一步专科治疗之前,患者各项生命体征及检测指标逐渐趋于平稳.函数推算支持此结果. 结论院内急救有效的治疗,及时控制各项指标稳定,正确判断伤情,提高院内急救一切合理措施,有助于提高交通事故性重型颅脑损伤患者的急救质量.
목적 통과대교통사고성중형로뇌손상재원내급구기간각생명체정、의식、동공급시간등배절상적변화,현시원내급구적중요성화일반규률,위아국상관부문제정급성로뇌창상적예방화공제조시주출삼고의거. 방법 이남방의과대학주강의원신경외과조직제정급71가의원전가위원회심정적《교통사고성중형로뇌손상통계표》위의거수집자2008년4월1일지2009년3월30일인교통사고치중형로뇌손상환자1107례적림상자료,근거재원내급구과정중환자의식상태、동공변화、GCS평분、혈압、호흡、맥박등지표재전입급전출급진과간적변화,진행함수추산,분석판단병정발전추세、창구효과화하일보치료조시. 결과 근거원내급구시간현시재10～60 min내입급진적환자최다,우기재10～30 min점총취진환자적38.9％.직관발현,환자경과원내급구유효치료후,의식상태、동공변화、GCS평분、혈압、호흡、맥박등지표중표현차적환자례수축점감소,표현중등、교호화호적례수증다,재진입하일보전과치료지전,환자각항생명체정급검측지표축점추우평은.함수추산지지차결과. 결론 원내급구유효적치료,급시공제각항지표은정,정학판단상정,제고원내급구일절합리조시,유조우제고교통사고성중형로뇌손상환자적급구질량.
Objective To make reference for relevant departments of our country to develop acute craniocerebral trauma prevention and control measures based on the general rule of hospital first aid by changing the links as signs of life, consciousness, pupil and time for hospital emergency in patients with traffic accident severe traumatic brain injury. Methods The clinical data of 1107 patients with severe traumatic brain injury,collected from April 1,2008 to March 30,2009,were analyzed; these patients were chosen according to the severe traumatic brain injury statistical table made by Department of Neurosurgery of Zhujiang Hospital and authorized by committee of experts from 71 other hospitals.The consciousness,pupil changes,GCS scores,blood pressure, respiration,pulse index changes on admission and at time out of emergency department were analyzed and compared; according to these results,function projections was performed; development tendency of the disease and rescue effect were judged, and the next treatment measure step was determined. Results According to the hospital emergency time,most patients got to the Emergency at 10-60 min after the injury,mostly at 10-30 min after the injury (38.9％).The consciousness,pupil changes,GCS scores,blood pressure,respiration,pulse index changes of most patients gradually developed to good trends after hospital first aid; before the patients received further specific treatment, the vital signs and indicators of them were gradually stabilized. Function projections supported these results. Conclusion Hospital first aid and effective treatment,timely controlling indicators,correct diagnosis and all reasonable measures improving hospital first aid can help to improve the first aid quality of patients with traffic accident severe traumatic brain injury.