摘要
目的 评估血流动力学不稳定骨盆骨折患者多维救治模式的临床应用效果。方法 回顾性分析自2018-01-2023-12诊治的109例血流动力学不稳定骨盆骨折,59例采用多学科、多阶段干预的多维救治模式(观察组),50例采用常规救治模式(对照组)。比较两组急诊停留时间、接诊至输血时间、术前准备时间、初诊漏诊、不良事件发生率、早期死亡率、出院好转率、出院18个月世界卫生组织生存质量测定简表评分。结果 观察组成功救治56例,3例死亡(1例因严重失血性休克死亡,2例因腹腔感染、多脏器功能衰竭在3周内死亡)。对照组成功救治44例,6例死亡(3例因严重失血性休克死亡,3例因腹腔感染、肺部感染及多脏器功能衰竭在4周内死亡)。观察组急诊停留时间、接诊至输血时间、术前准备时间较对照组短,初诊漏诊率、不良事件发生率、早期死亡率低于对照组,出院好转率、出院18个月世界卫生组织生存质量测定简表评分高于对照组,差异有统计学意义(P<0.05)。结论 对血流动力学不稳定骨盆骨折患者实施多学科、多阶段干预多维救治模式更具时效性和科学性,缩短了急诊停留时间、入院至输血时间和术前准备时间,降低了初诊漏诊率、不良事件发生率及早期死亡率,提高了出院好转率和生活质量。
Objective To evaluate the clinical application effect of multidimensional treatment mode in patients with hemody-namically unstable pelvic fractures.Methods A retrospective analysis was performed on 109 cases of hemodynamically unsta-ble pelvic fractures diagnosed and treated from January 2018 to December 2023.Fifty-nine cases were treated with multidisci-plinary team and multi-stage intervention(observation group),and 50 cases were treated with conventional treatment mode(con-trol group).The time of stay in the emergency department,the time from reception to blood transfusion,the time of preoperative preparation,the missed diagnosis at the beginning,the incidence of adverse events,the early mortality rate,the improvement rate of discharge,and the World Health Organization Quality of Life Short Form score at 18 months after discharge were com-pared between the two groups.Results In the observation group 56 cases were successfully treated and 3 died(1 case due to severe hemorrhagic shock,and 2 cases within 3 weeks due to abdominal infection and multiple organ failure).In the control group 44 cases were successfully treated and 6 died(3 due to severe hemorrhagic shock,and 3 within 4 weeks due to abdominal infection,lung infection and multiple organ failure).The emergency department stay time,the time from reception to blood trans-fusion,and the preoperative preparation time in the observation group were shorter than those in the control group,and the rate of missed diagnosis,adverse events,and early mortality rate were lower than those in the control group,and the improvement rate of discharge and the World Health Organization Quality of Life Test Short Form score at 18 months after discharge were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion The new multi-dimen-sional treatment mode of multidisciplinary team and multi-stage intervention for patients with hemodynamically unstable pelvic fractures is more timely and more scientific,shortening the emergency department stay time,admission to blood transfusion time and preoperative preparation time,reducing the rate of initial missed diagnosis,the incidence of adverse events and early mortal-ity,and improving the discharge improvement rate and quality of life.
作者
陶春生
赵金柱
孙培锋
胡健
曲良
TAO Chunsheng;ZHAO Jinzhu;SUN Peifeng;HU Jian;QU Liang(Department of Orthopedics,the 971st Hospital of the PLA Navy,Qingdao,Shandong 266071,China)
出处
《中国骨与关节损伤杂志》
2025年第8期785-788,共4页
Chinese Journal of Bone and Joint Injury
基金
青岛市医疗卫生优秀人才培养项目(青卫科教字[2024]3号)
军队临床培育专科建设项目(2024)。
关键词
骨盆骨折
血流动力学不稳定
多维救治模式
失血性休克
Pelvic fracture
Hemodynamic instability
Multi-dimensional treatment model
Hemorrhagic shock
