Application Effect of Whole-process Management Based on Rapid Rehabilitation Combined with Damage Control in Multiple Injuries
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摘要:
目的 探讨基于快速康复的全程化管理联合损伤控制在多发伤中的应用效果。 方法 选取昆明医科大学附属红河医院2019年1月至2020年12月采用传统专科救治模式的多发伤患者43例作为对照组,选取昆明医科大学附属红河医院2021年1月至2022年12月采用基于快速康复的全程化管理联合损伤控制性手术救治模式的多发伤患者43例作为观察组,比较2组抢救反应时间、现场救治时间、预警时间、转入ICU时间、输液量、输血量、住院时间、住院费用、救治成功率,以及不良反应发生情况。 结果 观察组抢救反应时间、现场救治时间、预警时间、转入ICU时间、住院时间明显短于对照组(P < 0.05),观察组输液量、输血量明显少于对照组(P < 0.05),观察组住院费用明显高于对照组(P < 0.05),观察组救治成功率(95.35% vs 81.40%),明显高于对照组(P < 0.05)。观察组血栓发生率(9.30% vs 13.95%)、弥漫性血管内凝血发生率(0.00% vs 4.65%)、肺部感染发生率(4.65% vs 9.30%)、肺不张发生率(0.00% vs 4.65%)与对照组比较,均无统计学意义(P﹥0.05),观察组并发症发生率(13.95% vs 32.56%)明显低于对照组(P < 0.05)。 结论 基于快速康复的全程化管理联合损伤控制应用于多发伤中,可有效提高抢救效率和救治成功率,减少并发症,加快患者恢复。 Abstract:Objective To explore the application effect of whole-process management combined with injury control based on rapid rehabilitation in multiple injuries. Methods 43 patients with multiple injuries treated with the traditional specialized treatment mode at the Affiliated Honghe Hospital of Kunming Medical University from January 2019 to December 2020 were selected as the control group. 43 patients with multiple injuries treated with the whole-process management and injury control surgery mode based on rapid rehabilitation at the Affiliated Honghe Hospital of Kunming Medical University from January 2021 to December 2022 were selected as the observation group. The rescue response time, on-site treatment time, warning time, ICU admission time, fluid volume, blood transfusion volume, length of hospital stay, hospitalization costs, treatment success rate, and occurrence of adverse reactions were compared between the two groups. Results The observation group had significantly shorter rescue response time, on-site treatment time, warning time, ICU admission time, and hospital stay compared to the control group (P < 0.05). The observation group had significantly less fluid and blood transfusion volume than the control group (P < 0.05), but had significantly higher hospitalization costs than the control group (P < 0.05). The observation group had a significantly higher treatment success rate (95.35% vs 81.40%) compared to the control group (P < 0.05). There was no statistically significant difference in the incidence of thrombosis (9.30% vs 13.95%), disseminated intravascular coagulation (0.00% vs 4.65%), pulmonary infection (4.65% vs 9.30%), and pulmonary atelectasis (0.00% vs 4.65%) between the observation group and the control group (P > 0.05). The incidence of complications in the observation group (13.95% vs 32.56%) was significantly lower than that in the control group (P < 0.05). Conclusion The application of whole-process management based on rapid rehabilitation combined with injury control in multiple injuries can effectively improve the rescue efficiency and the success rate of treatment, reduce adverse reactions and accelerate the recovery of patients. -
Key words:
- Rapid rehabilitation /
- Whole process management /
- Damage control /
- Multiple injuries
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表 1 2组基线资料比较(
$ \bar x \pm s $ )Table 1. Comparison of baseline data between the two groups (
$ \bar x \pm s $ )组别 n 年龄(岁) 性别[n(%)] ISS评分 致伤原因[n(%)] 男 女 交通意外 高处坠落 重物砸伤 斗殴致伤 观察组 43 43.89 ± 10.44 32(74.42) 11(25.58) 33.88 ± 7.79 29(67.44) 5(11.63) 6(13.95) 2(4.65) 对照组 43 43.55 ± 11.27 30(69.77) 13(30.23) 31.76 ± 7.01 29(67.44) 5(11.63) 7(16.28) 2(4.65) t/χ2 0.145 0.231 1.327 0.350 P 0.885 0.631 0.188 0.554 表 2 并发症发生情况比较[n(%)]
Table 2. Comparison of the occurrence of complications [n(%)]
组别 n 血栓 弥漫性血管内凝血 肺部感染 肺不张 不良反应 观察组 43 4(9.30) 0(0.00) 2(4.65) 0(0.00) 6(13.95) 对照组 43 6(13.95) 2(4.65) 4(9.30) 2(4.65) 14(32.56) F/χ2 0.453 − − − 4.170 P 0.501 0.494* 0.676* 0.494* 0.041 注:*fisher精确检验的P值。 -
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