CAJ | 학술논문

目的探讨创伤数据库信息管理系统优化流程对批量创伤救治的作用. 方法采集上海市浦东新区人民医院创伤数据库系统2011年1-12月收录的交通事故批量创伤事件中的16批次89例患者的相关数据,设为信息化救治组(研究组).同时采集实行创伤数据库信息化管理前的2010年1-12月交通批量创伤14批次78例患者的数据,作为传统救治组(对照组),对两组患者资料进行回顾性比较分析.指标包括患者一般资料(年龄、性别、创伤部位、ISS评分、救治转归等)、急救反应时间(急救到达现场用时、急救现场用时、转送医院用时、急诊滞留时间、受伤至手术开始时间等)以及不同创伤严重程度患者救治结局等. 结果两组患者性别比例、年龄、受伤部位、多发伤构成比及ISS评分等差异均无统计学意义(P＞0.05).到达现场用时和转送医院用时研究组分别为(16.3±12.8) min和(10.4±3.3) min,对照组分别为(18.1±14.3) min和(10.9±6.2) min,差异均无统计学意义(P＞0.05).研究组和对照组急救现场用时[(12.6±8.2) min∶ (25.4±10.4) min,P＜0.05]、急诊滞留时间[(35.7±19.1) min∶ (82.3±38.8) min,P＜0.01]和受伤至手术时间[(66.5±21.5) min∶ (117.7±45.3) min,P＜0.01],差异均有统计学意义.研究组总体好转率显著优于对照组(89％∶71％,P ＜0.05),其中ISS≥16分者差异尤为显著(87％∶68％,P＜0.01),而ISS＜ 16分者差异无统计学意义(94％∶79％,P＞0.05);ISS≥25分者中研究组好转率显著高于对照组(79％∶37％,P＜0.01). 结论应用创伤数据库信息化管理可显著优化批量创伤救治流程,缩短急救反应时间,提高创伤尤其是严重创伤患者的救治成功率.
목적 탐토창상수거고신식관리계통우화류정대비량창상구치적작용. 방법 채집상해시포동신구인민의원창상수거고계통2011년1-12월수록적교통사고비량창상사건중적16비차89례환자적상관수거,설위신식화구치조(연구조).동시채집실행창상수거고신식화관리전적2010년1-12월교통비량창상14비차78례환자적수거,작위전통구치조(대조조),대량조환자자료진행회고성비교분석.지표포괄환자일반자료(년령、성별、창상부위、ISS평분、구치전귀등)、급구반응시간(급구도체현장용시、급구현장용시、전송의원용시、급진체류시간、수상지수술개시시간등)이급불동창상엄중정도환자구치결국등. 결과 량조환자성별비례、년령、수상부위、다발상구성비급ISS평분등차이균무통계학의의(P＞0.05).도체현장용시화전송의원용시연구조분별위(16.3±12.8) min화(10.4±3.3) min,대조조분별위(18.1±14.3) min화(10.9±6.2) min,차이균무통계학의의(P＞0.05).연구조화대조조급구현장용시[(12.6±8.2) min∶ (25.4±10.4) min,P＜0.05]、급진체류시간[(35.7±19.1) min∶ (82.3±38.8) min,P＜0.01]화수상지수술시간[(66.5±21.5) min∶ (117.7±45.3) min,P＜0.01],차이균유통계학의의.연구조총체호전솔현저우우대조조(89％∶71％,P ＜0.05),기중ISS≥16분자차이우위현저(87％∶68％,P＜0.01),이ISS＜ 16분자차이무통계학의의(94％∶79％,P＞0.05);ISS≥25분자중연구조호전솔현저고우대조조(79％∶37％,P＜0.01). 결론 응용창상수거고신식화관리가현저우화비량창상구치류정,축단급구반응시간,제고창상우기시엄중창상환자적구치성공솔.
Objective To investigate the role of optimized process of the trauma information management system in treatment of mass trauma.Methods Eighty-nine cases injured from the 16th mass traffic events documented in the trauma database system in People' s Hospital of Pudong New Area between January 2011 and December 2011 were defined as the informationalized treatment group (study group),while additional 78 cases injured from the 14th mass traffic events between January 2010 and December 2010 prior to the utilization of trauma database system were used as the conventional treatment group (control group).Statistical parameters were studied retrospectively,including general clinical data (age,gender,trauma sites,ISS score,treatment and outcome,etc),emergency reaction time (the time used for emergency rescue arriving at the scene of an accident,time for on-site treatments,transfer time,residence time in emergency room,time from injury to operation,etc) and treatment outcome of patients with different degree of trauma.Results There were no significant differences between the two groups in aspects of gender,age,sites of injury,constituent ratio of multiple injuries and ISS score (P ＞ 0.05).Control group had no marked differences from control group for the time used in emergency rescue arriving at the accident scene [(16.3 ± 12.8) min vs (18.1 ± 14.3) min] and the time taken to transfer patients [(10.4 ± 3.3) min vs (10.9-± 6.2) min] (P ＞ 0.05).However,the differences were significant between study group and control group in aspects of time for on-site treatments [(12.6 ± 8.2) min vs (25.4 ± 10.4) min,P ＜ 0.05] and residence time in emergency room [(35.7 ± 19.1) min vs (82.3 ±38.8) min,P ＜ 0.01] and time from injury to operation [(66.5 ± 21.5) min vs (117.7 ± 45.3) min,P ＜0.01].Overall improvement rate in study group was significantly better than that in control group (89％ vs 71％,P ＜0.05),especially in the patients with ISS≥16 points (87％ vs 68％,P ＜0.01).However,there was no statistical difference in the patients with ISS ＜ 16 points of the two groups (94％vs 79％,P ＞ 0.05).For the patients with ISS≥25 points,the improvement rate in study group was significantly better that in control group (79％ vs 37％,P ＜ 0.01).Conclusion Trauma database information management optimizes the process for mass trauma care,shortens emergency response time and improves the treatment success rate,especially for the patients with severe trauma.