林正奎 罗毅 黄瀛 翟崇宇 刘路培

【摘要】 目的 探讨院前创伤指数评分结合院内远程网络会诊平台在创伤患者急救中的应用效果。方法 将纳入研究的300例创伤患者，随机分为观察组（采用院前创伤指数评分结合院内远程网络会诊平台进行急救）和对照组（仅采用院内远程网络会诊平台进行急救），每组150例。观察两组的临床疗效，比较两组患者受伤部位、受伤类型、确定性手术治疗时间、平均住院时间、创伤预后。结果 观察组与对照组受伤部位、受伤类型比较无统计学意义（P>0.05），观察组确定性手术治疗时间、平均住院时间均低于对照组（P<0.05），创伤预后优于对照组（P<0.05）。结论 院前创伤指数评分结合院内远程网络会诊平台的规范实施是创伤患者院前急救重要且有效的方法。

【关键词】 创伤；创伤指数评分；院内远程网络会诊平台；多学科联合会诊

中图分类号：R64 文献标识码：A DOI：10.3969/j.issn.1003-1383.2018.03.009

【Abstract】 Objective To explore the application effect of pre-hospital trauma index score combined with in-hospital remote network consultation platform in the emergency treatment of trauma patients.Methods 300 patients with trauma were randomly divided into observation group and control group，with 150 cases in each group.The observation group were given pre-hospital trauma index score combined with in-hospital remote network consultation platform for first aid，and the control group were given only in-hospital remote network consultation platform.The clinical efficacy of the two groups was observed.And injury locations，injury types，deterministic operative time，average hospitalization time，and trauma prognosis of the two groups were compared.Results There was no statistically significant difference in the injury locations and injury types between the observation group and the control group（P>0.05）.The deterministic operative time and average hospitalization time in the observation group were shorter than those in the control group（P<0.05），and trauma prognosis was better than that of the control group（P<0.05）.Conclusion The standardized implementation of pre-hospital trauma index score combined with the in-hospital remote network consultation platform is an important and effective method for pre-hospital first aid of trauma patients.

【Key words】 trauma；trauma index score；in-hospital remote network consultation platform；multidisciplinary joint consultation

意外傷害已经成为人类死亡的主要因素之一，创伤已被认为是“社会发达性疾病”，创伤人数日趋增加，其所造成的高致残率及高致死率会对家庭及社会造成巨大损失。由于创伤的治疗时间窗很短，所以创伤的院前急救医学干预十分必要和重要。创伤评分作为评价创伤严重程度的量化标准，已经成为研究院前急救、院内救治的必要客观指标。我院目前采用创伤指数评分（Trauma index，TI）首先在急救现场快速、准确、客观地评估患者伤情严重程度，然后通过院内远程会诊平台对患者进行相关外科专业的多学科联合会诊，在患者转运回院途中已完成外科专业多学科联合会诊，极大缩短院内多科会诊时间及确定性手术治疗时间，针对极危重患者甚至可达到将控制性创伤手术技术前移至急诊科，对创伤患者的诊断、救治及预后等方面都具有重要意义。为……