继续医学教育
繼續醫學教育
계속의학교육
CONTINUING MEDICAL EDUCATION
2015年
5期
49-50
,共2页
基层医院%蛛网膜下腔出血%院前急救%急诊%多因素分析
基層醫院%蛛網膜下腔齣血%院前急救%急診%多因素分析
기층의원%주망막하강출혈%원전급구%급진%다인소분석
Primary hospital%Subarachnoid hemorrhage%First aid%Emergency%Multiple factors analysis
目的：探讨基层医院院前急救及多通道合作对蛛网膜下腔出血的病因诊断及疗效的影响，初步分析预后的影响因素。方法回顾性分析2012年8月～2014年8月间，行院前急救及多通道合作救治的37例蛛网膜下腔出血患者资料。对其行院前急救，安全转送至医院后，统计患者院前急救及转运结局、发病至医院急诊时间及患者预后；统计患者年龄、高血压史、糖尿病史等一般信息，行多因素回归分析，明确患者预后的影响因素。结果院前急救期间死亡3例，余34例均安全转送入院，发病至医院急症时间平均（3.2±0.4）h。转诊治疗7例，死亡0例、再出血1例；非转诊治疗27例，均行保守治疗，死亡3例、再出血4例。患者预后与年龄、高血压史、转运与否、发病至医院急诊时间显著相关（P＜0.05）。结论院前急救及多通道合作是基层医院处理蛛网膜下腔出血的有效方案；患者预后与其年龄、既往史等一般资料密切相关，临床救治必须重视此类信息。
目的：探討基層醫院院前急救及多通道閤作對蛛網膜下腔齣血的病因診斷及療效的影響，初步分析預後的影響因素。方法迴顧性分析2012年8月～2014年8月間，行院前急救及多通道閤作救治的37例蛛網膜下腔齣血患者資料。對其行院前急救，安全轉送至醫院後，統計患者院前急救及轉運結跼、髮病至醫院急診時間及患者預後；統計患者年齡、高血壓史、糖尿病史等一般信息，行多因素迴歸分析，明確患者預後的影響因素。結果院前急救期間死亡3例，餘34例均安全轉送入院，髮病至醫院急癥時間平均（3.2±0.4）h。轉診治療7例，死亡0例、再齣血1例；非轉診治療27例，均行保守治療，死亡3例、再齣血4例。患者預後與年齡、高血壓史、轉運與否、髮病至醫院急診時間顯著相關（P＜0.05）。結論院前急救及多通道閤作是基層醫院處理蛛網膜下腔齣血的有效方案；患者預後與其年齡、既往史等一般資料密切相關，臨床救治必鬚重視此類信息。
목적：탐토기층의원원전급구급다통도합작대주망막하강출혈적병인진단급료효적영향，초보분석예후적영향인소。방법회고성분석2012년8월～2014년8월간，행원전급구급다통도합작구치적37례주망막하강출혈환자자료。대기행원전급구，안전전송지의원후，통계환자원전급구급전운결국、발병지의원급진시간급환자예후；통계환자년령、고혈압사、당뇨병사등일반신식，행다인소회귀분석，명학환자예후적영향인소。결과원전급구기간사망3례，여34례균안전전송입원，발병지의원급증시간평균（3.2±0.4）h。전진치료7례，사망0례、재출혈1례；비전진치료27례，균행보수치료，사망3례、재출혈4례。환자예후여년령、고혈압사、전운여부、발병지의원급진시간현저상관（P＜0.05）。결론원전급구급다통도합작시기층의원처리주망막하강출혈적유효방안；환자예후여기년령、기왕사등일반자료밀절상관，림상구치필수중시차류신식。
ObjectiveTo explore the effect of primary hospital ifrst-aid and multi-channel cooperation on etiological diagnosis and curative effect of subarachnoid hemorrhage, a preliminary analysis of the inlfuence factors of prognosis.MethodsRetrospective analysis of 2012 August to 2014 August, for pre hospital emergency care and multi channels of cooperation in treatment of 37 cases of subarachnoid hemorrhage patients data. In the pre hospital emergency care, safety and transferred to the hospital, and statistics were pre hospital emergency care and transport outcome, onset to hospital emergency time and the prognosis of the patients, statistical patient age, history of hypertension, history of diabetes and other general information, analysis for multiple factors regression, the factors affecting the prognosis of patients with clear.Results The prehospital period 3 cases of death, the remaining 34 cases security transfer admission, onset to hospital emergency time average (3.2±0.4) h. Referral for treatment of 7 cases, 0 cases of death, 1 cases rebleeding, non referral treated 27 cases underwent conservative treatment, 3 cases of death, 4 cases rebleeding. The prognosis of patients with significant correlation with age, hypertension history, transfer or not, onset to hospital emergency time (P<0.05). ConclusionPrehospital and multi-channel cooperation is the primary hospital treatment effective scheme arachnoid subarachnoid hemorrhage; prognosis of patients with general information age, previous history is closely related to the clinical treatment must pay attention to such information.
