CAJ | 학술논문

目的：阐明中美两国综合性医院急诊医学科道路交通伤患者的异同点，为两国在道路交通伤临床、教学和科研方面的进一步合作提供新思路。方法选取2013年11—12月中国浙江省人民医院急诊医学科和2013年7—9月美国纽约州立大学上州医科大学急诊医学科两家单位的道路交通伤患者作为调查对象。双方合作设计《mⅤC Survey Questionare》（中英文版），供两家单位开展问卷调查。调查方法为标准流行病学抽样调查。调查内容包括患者到达急诊医学科的方式、交通工具、损伤类型、影像学检查情况、会诊情况、转归等。结果共发放问卷425份，回收合格问卷399份，有效率为93.9%，其中中国有效问卷155份，美国244份。到达急诊医学科的方式：美国道路交通伤患者救护车使用率高于中国，自备车使用率低于中国（ P<0.05）。交通工具：美国自行车、电动车、行人交通事故发生率低于中国，汽车交通事故发生率高于中国（ P<0.05）。损伤类型：美国患者颅脑、皮肤软组织损伤发生率低于中国，胸部损伤、骨折发生率高于中国（ P<0.05）。影像学检查：美国患者X线、CT检查率均高于中国（ P<0.05）。两国住院率、病死率、救治成功出院率、入住ICU比例、急诊手术率比较，差异均无统计学意义（ P>0.05）。结论与美国相比，中国较少选择救护车转运道路交通伤患者。中国有更多类型的机动车涉及道路交通伤事故，中国道路交通伤患者中骑电动车、摩托车和行人的比例较高，这在一定程度上导致了中国颅脑损伤的比例远高于美国。另外，中国患者影像学检查率明显低于美国。上述差异为未来双方在道路交通伤临床、教学和科研方面开展进一步合作提供了新思路。
목적：천명중미량국종합성의원급진의학과도로교통상환자적이동점，위량국재도로교통상림상、교학화과연방면적진일보합작제공신사로。방법선취2013년11—12월중국절강성인민의원급진의학과화2013년7—9월미국뉴약주립대학상주의과대학급진의학과량가단위적도로교통상환자작위조사대상。쌍방합작설계《mⅤC Survey Questionare》（중영문판），공량가단위개전문권조사。조사방법위표준류행병학추양조사。조사내용포괄환자도체급진의학과적방식、교통공구、손상류형、영상학검사정황、회진정황、전귀등。결과공발방문권425빈，회수합격문권399빈，유효솔위93.9%，기중중국유효문권155빈，미국244빈。도체급진의학과적방식：미국도로교통상환자구호차사용솔고우중국，자비차사용솔저우중국（ P<0.05）。교통공구：미국자행차、전동차、행인교통사고발생솔저우중국，기차교통사고발생솔고우중국（ P<0.05）。손상류형：미국환자로뇌、피부연조직손상발생솔저우중국，흉부손상、골절발생솔고우중국（ P<0.05）。영상학검사：미국환자X선、CT검사솔균고우중국（ P<0.05）。량국주원솔、병사솔、구치성공출원솔、입주ICU비례、급진수술솔비교，차이균무통계학의의（ P>0.05）。결론여미국상비，중국교소선택구호차전운도로교통상환자。중국유경다류형적궤동차섭급도로교통상사고，중국도로교통상환자중기전동차、마탁차화행인적비례교고，저재일정정도상도치료중국로뇌손상적비례원고우미국。령외，중국환자영상학검사솔명현저우미국。상술차이위미래쌍방재도로교통상림상、교학화과연방면개전진일보합작제공료신사로。
Objective To identify the similarities and differences in patients with traffic injury received by the department of emergency medicine of general hospitals between China and America,in order to provide new thoughts for the further cooperation between the two countries in the clinical practice,education and research of traffic injury. Methods We enrolled patients with traffic injury received by the Department of Emergency medicine of the People′s Hospital of Zhengjiang Province from November to December,2013 and the Department of Emergency medicine of Upstate medical University of State University of New York from July to September,2013. mⅤC Survey Questionnaire( Chinese and English versions) was jointly designed by the two hospitals for the use of investigation. The standard epidemiology sampling method was employed. The survey content included the method of delivering patients to hospital,transportation means,injury type,imaging examination rate, consultation with doctors, outcomes, etc. Results A total of 425 questionnaires were distributed, and 399 effective questionnaires were returned with an effective rate of 93. 9%,among which 155 were from China and 244 were from America. For the method of delivering patients to hospital,the rates of American patients who were delivered to hospital by ambulance was higher(P<0. 05)than that of Chinese patients,and the rates of American patients who were delivered to hospital by self-provided automobiles was lower ( P <0. 05 ) than that of Chinese patients. For the transportation means, the incidence of American patients injured on bicycles,electric bicycles and while walking was lower(P<0. 05)than that of Chinese patients, and the incidence of American patients injured in automobiles was higher(P<0. 05)than that of Chinese patients. For injury type,the incidence of injury in brain and skin soft tissue of American patients was higher ( P <0. 05 ) than that of Chinese patients,and the incidence of chest injury and bone fracture of American patients was higher(P<0. 05)than that of Chinese patients. For imaging examination,the rates of X-ray and CT examination of American patients were higher(P<0. 05)than those of Chinese patients. There were no significant differences ( P >0. 05 ) in hospitalization rate, mortality, the rate of hospital discharge after successful rescue,the rate of ICU admission and the rate of emergent rescue operation between American patients and Chinese patients. Conclusion Compared with America,China makes less use of ambulances to deliver patients with traffic injury to hospital. China has more types of motor vehicles involved in traffic injuries,and the proportion of Chinese patients injured on electric bicycles and motorcycles and while walking is higher than that of American patients,which makes the proportion of Chinese patients with brain injury higher than American patients. Besides,the rate of receiving imaging examination of Chinese patients is evidently lower than that of American patients. These differences illustrated above will provide new thoughts for the further cooperation between the two countries in the clinical practice,teaching and research of traffic injury.