摘要
目的 探讨紧急多学科团队合作诊疗模式(EMDT)在重型颅脑损伤合并多发伤抢救中的临床价值。方法 选取2018年9月至2021年2月广西国际壮医医院急诊科接诊的重型颅脑损伤合并多发伤患者96例作为研究对象,选择2018年9月至2019年5月进行传统(多专科会诊分流至各专科手术治疗)治疗患者为传统组(n=42),选择2019年6月至2021年2月进行多学科治疗(由急诊创伤团队进行整体化救治)为EMDT组(n=54),收集患者的性别、年龄、合并损伤部位、受伤类型、格拉斯哥昏迷评分(GCS)、创伤严重程度评分(ISS)、颅脑损伤严重程度分级(AIS)、院前急救时间、院内急救时间、住院时间和6个月后随访格拉斯哥预后评分(GOS),并作统计学分析。结果 两组性别、年龄、合并损伤部位、受伤类型、GCS评分、ISS、AIS比较差异无统计学意义(P>0.05),而院前急救时间、院内急救时间、住院时间和6个月后GOS比较差异有统计学意义(P<0.05)。结论 EMDT在重型颅脑损伤合并多发伤抢救中能够明显缩短患者在急诊科的院内抢救时间,降低病死率,改善预后,值得临床推广。
Objective To explore the clinical value of emergency multi-disciplinary team(EMDT) cooperation diagnosis and treatment mode in the rescue of severe traumatic brain injury combined with multiple injuries. Methods A total of 96 patients with severe traumatic brain injury and multiple injuries admitted to the emergency department of our hospital from September 2018 to February 2021 were selected as the research objects. The patients with traditional treatment(multi-specialist consultation, then diversion to each specialized consulting room with surgical treatment) from September 2018 to May 2019 were selected as the traditional group(n=42), and the patients with the multi-disciplinary treatment(integrated treatment by the emergency trauma team) from June 2019 to February 2021 were selected as EMDT group(n=54). The patient′s gender, age, combined injury site, injury type, Glasgow coma score(GCS), injury severity score(ISS), abbreviated injury scale(AIS), pre-hospital first-aid time, hospital emergency time, hospital stay and 6-month follow-up Glasgow outcome scale(GOS) were collected and analyzed statistically. Results There were no statistical significance in terms of gender, age, combined injury site, injury type, GCS, ISS and AIS between the two groups(P>0.05);while pre-hospital first-aid time, in-hospital emergency time, hospital stay and 6-month GOS existed obviously statistical significance(P<0.05).Conclusions The EMDT can significantly shorten the patient′s stay time in the emergency department, reduce the mortality, improve the patient prognosis. It is worthy of widespread application.
作者
徐家旋
蔡利
黄东振
牟思曈
唐日新
何祖豪
唐甜
闫美花
孙婷
唐华民
Xu Jia-xuan;Cai Li;Huang Dong-zheng;Mou Si-tong;Tang Ri-xin;He Zu-hao;Tang Tian;Yan Mei-hua;Sun Ting;Tang Hua-min(Department of Emergency,Guangxi International Zhuang Medical Hospital,Nanning 530201,China)
出处
《中国急救医学》
CAS
CSCD
2023年第3期186-190,共5页
Chinese Journal of Critical Care Medicine
基金
国家自然科学基金(81660327)
广西卫健委计划课题(Z20200514)
广西科技基地和人才专项(桂科AD22035052)。
