摘要
目的:探讨创伤中心模式下介入手术干预时机前移对危重症创伤患者早期救治效果的影响。方法:纳入2022年5月至2024年12月东莞市厚街医院收治的60例危重症创伤患者,以随机数字表法将其分为对照组(复苏满意后行介入手术)和观察组(复苏同步介入手术),各30例。比较两组患者格拉斯哥昏迷量表(GCS)评分、休克指数、救治成功率、治疗效果、血流动力学指标[经皮动脉血氧饱和度(SpO_(2))、平均动脉压(MAP)、心率(HR)]、血液制品用量、凝血指标[血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]及并发症发生情况。结果:术后24 h、72 h观察组GCS评分高于对照组,休克指数低于对照组(P <0.05)。与对照组相比,观察组患者救治成功率和治疗总有效率较高,血液制品用量较少,凝血指标时间较短,并发症发生率较低(P <0.05)。两组患者术后24 h、72 h时HR较术前均降低(P <0.05),但组间血流动力学指标水平比较,差异无统计学意义(P> 0.05)。结论:在创伤中心模式下将介入手术干预时机前移至复苏同步阶段,可显著提高危重症创伤患者救治成功率,减少血液制品输注,改善凝血功能,并降低并发症风险。
Objective To investigate the impact of advancing the timing of interventional surgery to the resuscitation phase under a trauma center model on early treatment outcomes in critically ill trauma patients.Methods Sixty critically ill trauma patients admitted to Houjie Hospital in Dongguan City from May 2022 to December 2024 were included.They were divided into the control group(undergoing interventional surgery after satisfactory resuscitation)and the observation group(undergoing interventional surgery simultaneously with resuscitation)by the random number table method,with 30 cases in each group.The Glasgow Coma Scale(GCS)score,shock index,treatment success rate,therapeutic effect,hemodynamic indicators[percutaneous arterial oxygen saturation(SpO_(2)),mean arterial pressure(MAP),heart rate(HR)],blood product dosage,and coagulation indicators[plasma prothrombin time(PT),activated partial thrombotic enzyme time(APTT)]of the two groups of patients were compared and the occurrence of complications.Results At 24 h and 72 h after the operation,the GCS score of the observation group was higher than that of the control group,and the shock index was lower than that of the control group(P<0.05).Compared with the control group,the success rate of treatment and the total effective rate of treatment in the observation group were higher,the amount of blood products used was less,the time of coagulation indicators was shorter,and the incidence of complications was lower(P<0.05).The HR of both groups of patients at 24 h and 72 h after the operation was lower than that before the operation(P<0.05),but there was no statistically significant difference in the levels of hemodynamic indicators between the groups(P>0.05).Conclusion Under the trauma center model,advancing interventional surgery to synchronize with resuscitation significantly improves treatment success rates,reduces blood product transfusion requirements,enhances coagulation function,and lowers complication risks in critically ill trauma patients.
作者
蔡舒
张锦清
黄波涛
李金庭
刘翔
陈甘海
CAI Shu;ZHANG Jinqing;HUANG Botao;LI Jinting;LIU Xiang;CHEN Ganhai(Intervention Department of Dongguan Houjie Hospital,Guangdong Dongguan 523945)
出处
《兵团医学》
2025年第1期15-19,共5页
Journal of BingTuan Medicine
基金
东莞市社会发展科技项目(20221800903852)
关键词
危重症创伤
介入手术
干预时机
Critically ill trauma
Interventional operation
Intervention timing
