卢书梅

摘 要 目的：探讨急救护理路径在抢救院前创伤性休克患者中的效果。方法：收集2015年1月—2016年5月实施院前急救的创伤性休克患者80例，分为对照组40例，采取创伤性休克常规护理；观察组40例，在对照组护理干预基础上，进行院前急救护理。观察两组患者抢救介入时间和术前准备时间，以及窒息和多器官衰竭（MODS）的发生情况。结果：观察组抢救成功率为92.50%（37/40），显著高于对照组的65.00%（26/40，P<0.05）。观察组患者入院前死亡、入院后抢救无效死亡率低于对照组（P<0.05），抢救介入时间、术前准备时间亦低于对照组（P<0.05）；窒息发生率、MODS发生率均显著低于对照组（P<0.05）。结论：急救护理路径在抢救院前创伤性休克患者中的效果较好，对于挽救患者生命具有重要意义。

关键词 休克 急救护理 效果

中图分类号：R473.6 文献标志码：A 文章编号：1006-1533（2016）16-0030-03

Effect of emergency nursing path in the pre-hospital rescue of patients with traumatic shock

LU Shumei

（Emergency Department of Emergency Rescue Center of Xinyu， Jiangxi 338000， China）

ABSTRACT Objective： To investigate the effect of emergency nursing path in the pre-hospital rescue of patients with traumatic shock. Methods： From January 2015 to May 2016， 80 cases of traumatic shock in pre-hospital first aid were selected and divided into a control group with 40 cases who were treated with the routine nursing， and an observation group with 40 cases who were treated with pre-hospital emergency nursing based on the routine nursing. The rescue in time， preoperative preparation time， and occurrences of asphyxia and multiple organ failure （MODS） were observed in the patients of the two groups. Results： The salvage successful rate was 92.50%（37/40） in the observation group that was significantly higher than that in the control group 5% （26/40）（P<0.05）. The rescue invalid death rates before and after admission to hospital were lower in the observation group than those in the control group（P<0.05）. The rescue in time and preoperative preparation time were significantly lower in the observation group than those in the control group（P<0.05）. The incidences of asphyxia， and MODS were significantly lower in the observation group than those in the control group（P<0.05）. Conclusion： Pre-hospital emergency nursing path has a good effect in the rescue of patients with traumatic shock and great significance to save the life of patients.

KEYWORDS shock； emergency nursing； effect

创伤性休克是因严重创伤引起一定出血造成的休克，多为暴力击打或剧烈撞击所致。机体内部脏器损伤出血，循环受阻，机体代偿失调，对患者的生命造成严重威胁[1]。根据创伤性休克的临床特点，需要采取积极的院前急救护理措施，挽救患者生命。本文报道急救护理路径在抢救院前创伤性休克患者中的效果。

1 资料与方法

1.1 一般资料

随机抽取2015年1月—2016年5月我院实施院前急救的创伤性休克患者80例，均符合创伤性休克诊断标准[2]。按照随机数字表法将患者分为观察组和对照组各40例。观察组中，男性28例，女性12例，年龄为27～55岁，平均（39.45±6.77）岁；脏器损伤22例，多发性骨折13例，脏器合并骨折损伤3例，其他2例。对照组中，男性26例，女性14例，年龄为28～55岁，平均（38.66±6.94）岁；脏器损伤20例，多发性骨折15例，脏器合并骨折损伤3例，其他2例。两组患者的临床资料差异无统计学意义（P>0.05）。

1.2 方法

对照组采取创伤性休克的传统急救护理流程。接到120指令，医护人员上车执行急救任务，到达现场勘查评估，搬运患者至救护车，遵医嘱建立静脉通道，伤口包扎，保持呼吸道通畅，吸氧，心电监护，完善各种抢救记录。……