CAJ | 학술논문

目的：观察脊柱损伤合并多发伤患者的急诊预见性护理的效果，探讨脊柱损伤合并多发伤合理急诊护理的措施。方法本院急诊科接诊的86例脊柱损伤合并多发伤患者，按掷币法随机分为观察组（n＝44）和对照组（n＝42），观察组采用预见性护理，对照组应用常规护理。记录救护车到达时间（发病至救护车到达时间）、有效抢救时间（从救护车到达至患者入院治疗的时间）、急救成功率（判断标准为经抢救后，患者生命体征缓解，转入住院或手术等治疗）及患者负面情绪发生率（恐惧、焦虑、烦躁为主），并对结果进行统计学分析。结果两组救护车到达时间无统计学差异；观察组有效抢救时间（27．7±4．4） min，急救成功率95．5％，负面情绪发生率13．6％；对照组有效抢救时间（34．6±4．1）min，急救成功率80．9％，负面情绪发生率28．6％；两组比较差异均具有统计学意义（P＜0．05）。结论多发伤中脊柱脊髓损伤基本处理原则是抢救患者生命，因多发伤患者中脊柱脊髓损伤早期诊断困难、易漏诊，治疗上应严格限制颈部活动及防止脊髓进一步损伤，更是尤为重要。
목적：관찰척주손상합병다발상환자적급진예견성호리적효과，탐토척주손상합병다발상합리급진호리적조시。방법본원급진과접진적86례척주손상합병다발상환자，안척폐법수궤분위관찰조（n＝44）화대조조（n＝42），관찰조채용예견성호리，대조조응용상규호리。기록구호차도체시간（발병지구호차도체시간）、유효창구시간（종구호차도체지환자입원치료적시간）、급구성공솔（판단표준위경창구후，환자생명체정완해，전입주원혹수술등치료）급환자부면정서발생솔（공구、초필、번조위주），병대결과진행통계학분석。결과량조구호차도체시간무통계학차이；관찰조유효창구시간（27．7±4．4） min，급구성공솔95．5％，부면정서발생솔13．6％；대조조유효창구시간（34．6±4．1）min，급구성공솔80．9％，부면정서발생솔28．6％；량조비교차이균구유통계학의의（P＜0．05）。결론다발상중척주척수손상기본처리원칙시창구환자생명，인다발상환자중척주척수손상조기진단곤난、역루진，치료상응엄격한제경부활동급방지척수진일보손상，경시우위중요。
Objective To study the effect of emergency foresight nursing care and reasonable nursing measures on patients with spinal cord injury combined with multiple injuries .Methods Eighty-six patients with spinal cord injury and multiple trauma were enrolled in emergency department of this hospital from October 2010 to October 2013.According to the toss of a coin they were random-ly divided into the observation group ( n=44 ) and the control group ( n=42 ) .The observation group received foreseeable nursing whereas the control group shared routine nursing care .The ambulance arrival time ( the time from onset of disease to the ambulance ar-rival), the effective rescue time (the time from the ambulance rrival to patients ’ hospitalization), the successful rate of first aid (as a criterion, after the rescue , the vital signs of the patients were relieved and transfer to hospitalization or surgical treatment ) , and inci-dence and patients’ negative emotions (fear, anxiety, irritability) were recorded, and the results were statistically analyzed. Results There was no significant difference in ambulance arrival time .In observation group , the average effective rescue time was (27.7 ±4.4) min, the success rate of first aid was 95.5%, incidence of negative emotions was 13.6%.In the control group, the av-erage effective rescue time was (34.6 ±4.1) min, the success rate of first aid was 80.9%, and negative emotions incidence was 28.6%.The difference was significant ( P<0.05) between the two groups .Conclusions For multiple injuries with spinal cord inju-ry, the basic principle is to save the lives of patients .Owing to difficulties in early diagnosis and easily missed diagnosis of spinal cord injury in multiple trauma patients with spinal cord injury , neck mobility should be strictly limited and further spinal damage should be prevented, which is particularly important to the treatment .