摘要
目的探究世居高原和世居沿海城市院内创伤失血性休克患者的差异性。方法回顾性分析2017年1月—2019年8月西藏自治区日喀则市江孜县人民医院急诊外科收治的世居高原的创伤失血性休克患者(高原组)和上海市浦东新区人民医院急诊与重症医学科收治的世居沿海的创伤失血性休克患者(沿海组),各30例。高原组男性17例,女性13例;年龄16~72岁,平均43.2岁;沿海组男性15例,女性15例;年龄14~80岁,平均43.5岁。致伤原因是道路交通伤、坠落伤、锐器/钝器伤、挤压伤。采取同等治疗措施,观察其治疗前后心率(HR)、脉搏血氧饱和度(SpO_(2))、呼吸频率(RR)、收缩压(SBP)、舒张压(DBP)以及治疗效果的差异。结果治疗前与治疗后,高原组RR、SBP、DBP水平均显著高于沿海组,而SpO_(2)、HR水平显著低于沿海组(P<0.05)。高原组急诊治疗4h内抢救效果总有效率(97%)显著高于沿海组(73%),P<0.05。治疗后第1、2、3个月,高原组痊愈比例均高于沿海组,在第4个月及以后,高原组痊愈比例低于沿海组(P<0.05)。治疗后,高原组不良反应(肺水肿、脑水肿、心功能不全)发生率(17%)显著低于沿海组(43%,P<0.05)。结论世居高原地区与世居沿海地区的创伤失血性休克患者在急救前后的临床特征、治疗效果以及并发症方面有不同的表现,世居高原地区患者HR、SpO_(2)、RR、SBP、DBP有显著差异以及治疗效果显著优于世居沿海城市患者,临床上应当采取不同的急救处理进行对症治疗。
Objective To explore the differences of patients with traumatic hemorrhagic shock in hospital living in plateau and coastal cities.Methods The patients with traumatic hemorrhagic shock(plateau group)who lived in the plateau and the patients with traumatic hemorrhagic shock(coastal group)who lived in the coastal area treated in the emergency surgery department of Jiangzi County People’s Hospital of Tibet Autonomous Region and department of emergency and critical medicine,Shanghai Pudong new area people’s hospital from Jan.2017 to Aug.2019 were retrospectively collected.There were 30 patients in each group,17 males and 13 females in the plateau group,aged from 16 to 72 years(average,43.2 years);there were 15 males and 15 females in the coastal group,aged from 14 to 80 years(average,43.5 years).The treatment medthod was the same.The causes of injury included road traffic injury,falling injury,sharp/blunt injury and crush injury.The differences of heart rate(HR),pulse oxygen saturation(SpO_(2)),respiratory rate(RR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and therapeutic effect were observed.Results Before and after treatment,the levels of RR,SBP and DBP in the plateau group were significantly higher than those in the coastal group,while the levels of SpO_(2) and HR in the plateau group were significantly lower than those in the coastal group(P<0.05).The total effective rate of emergency treatment within 4 hours in the plateau group(97%)was significantly higher than that in the coastal group(73%,P<0.05).At 1,2 and 3 months after treatment,the proportion of patients recovered in the plateau group was higher than that in the coastal group,and the proportion of patients recovered in the plateau group was less than that in the coastal group at 4 months and after(P<0.05).After treatment,the total incidence of adverse events in the plateau group(17%)was significantly lower than that in the coastal group(43%,P<0.05).Conclusion The clinical characteristics,treatment effect and complications of patients w
作者
秦龙
赵连泽
侯坤
李敏
朱卫红
格桑
扎次
列确
南木珍
西洛普赤
周艳
范叶君
赵李克
万健
Qin Long;Zhao Lianze;Hou Kun;Li Min;Zhu Weihong;Ge Sang;Zha Ci;Lie Que;Nan Muzhen;Xi Luopuchi;Zhou Yan;Fan Yejun;Zhao Like;Wan Jian(Department of Emergency and Critical Medicine,Shanghai Pudong New Area People’s Hospital,Shanghai 201299,China;Department of Emergency and Surgery,Jiangzi County People’s Hospital of Tibet Autonomous Region,Tibet,Gyangze 857400,China)
出处
《创伤外科杂志》
2021年第10期767-770,共4页
Journal of Traumatic Surgery
基金
上海市医学重点专科建设项目(ZK2019C08)
上海市浦东新区卫生系统领先人才培养计划(PWRl2018-08)。
关键词
创伤失血性休克
临床特征
治疗效果
并发症
高原和沿海地区
traumatic hemorrhagic shock
clinical symptoms
treatment effect
complications
high altitude and coastal city
