摘要:目的: 通過分析地市級急救中心院前急救資料,探討ICD10疾病分類方法在院前急救中的實用性。 方法 :回顧性分析2007年1~12月份自貢市急救中心出診的全部有效急救患者的急診診斷以及隨訪診斷,使用ICD10編碼進行歸類,比較疾病性別構成比。 結果 :全年院前急救4109例,排5位的疾病分別為損傷、中毒和外因的某些其他后果(484%)、循環系統疾病(170%)、消化系統疾病(81%)、呼吸系統疾病(64%)、精神和行為障礙(52%),損傷、中毒和外因的某些其他后果、循環系統疾病以及消化系統疾病出診量男性多于女性(P＜005),耳和乳突疾病以及妊娠、分娩和產褥期疾病出診量女性多于男性(P＜005)。 結論 :采用ICD10標準對院前急救病譜分類有進一步探討的價值。Abstract: Objective: To investigate the value of ICD10 in prehospital care by the analysis of cases in Zigong Urgent Rescue Center. Methods : All cases of prehospital care during the year of 2007 were studied, whose emergency Diagnoses and followup diagnoses were recorded, and they were classified by international classification of diseases 10th revision (ICD10). The gender composition ratio of diseases was analyzed. Results : Four thousand one hundred and nine cases of prehospital care in 2007 were included. Topfive diseases were injury, poisoning and certain other consequences of external causes (484%), diseases of the circulatory system (170%), diseases of the digestive system (81%), diseases of the respiratory system (64%), and mental and behavioral disorders (52%) respectively. The amout of the male prehospital cases was more that of than the female’s in the diseases of injury, poisoning and certain other consequences of external causes, diseases of the circulatory system, diseases of the digestive system (P＜005); the amount of the female prehospital cases was more than that of the male’s in the diseases of the ear and mastoid process, pregnancy, childbirth and the puerperium (P＜005). Conclusion : Further research on the spectrum of diseases classified by ICD10 is valuable.
目的 調查在院前急救中醫患雙方對留置針使用的滿意度，并就留置針在急救中應用的合理性進行研究。 方法 將我院急診科2011年6月－8月院前急救的患者，按出診順序分為兩組，觀察組患者使用留置針穿刺建立靜脈通道，對照組則采用一次性靜脈輸液針，并調查患者或親屬、穿刺操作護士就兩種穿刺方法的滿意度。 結果 觀察組留置針一次穿刺成功者達198例（94.29%），對照組一次穿刺成功者為206例（88.79%），兩組比較差異有統計學意義（P＜0.05）；護士對留置針使用滿意度明顯高于一次性靜脈輸液針；患者及家屬對留置針在保持靜脈通道通暢、輸液肢體舒適的滿意度較一次性靜脈輸液針高。 結論 靜脈留置針在院前急救中能提高醫患雙方的滿意度，值得推廣使用。
Against the backdrop of the National Health Commission incorporating the “smart medical emergency care system construction” into the Guidelines for the Construction and Management of Critical Maternal and Fetal Care Centers, leveraging smart medical technologies such as artificial intelligence and 5G to advance the “pre-hospital to in-hospital integrated” emergency care system for critical cases has become a trend. Based on this, a technical specification for smart healthcare in pre-hospital emergency of emergency obstetrics and gynecology, including 5G and artificial intelligence, has been developed to clarify the standardized process, risk prevention and control, and multidisciplinary collaboration mechanism for pre-hospital emergency care and transportation of critically ill obstetrics and gynecology patients. This will shorten emergency response time, improve rescue efficiency, reduce maternal and infant mortality rates, and improve prognosis, which is crucial for enhancing regional rescue capabilities and ensuring maternal and infant safety.
目的 研究汶川地震后精神傷害對院前急救的影響。 方法 對2010年10月1日－2012年10月31日院前急救患者的地震后家庭成員狀況、精神傷害情況及病情程度進行回顧性病例對照分析。共有446例患者納入研究，男278例，女188例；年齡（41.4 ± 2.8）歲。依據家庭成員遇難狀況分3組，A組（家庭成員在地震中遇難）25例，B組（家庭成員在地震中受傷，無遇難情況）127例，C組（地震家庭成員完好）314例。 結果 各組患者最常見的精神傷害狀況是焦慮（A組96.0%，B組71.7%，C組40.8%）、過度警惕（A組92.0%，B組70.9%，C組50.0%），差異有統計學意義（P＜0.001）。A組患者要求到上級醫院繼續治療率較高（A組56.0%，B組39.4%，C組8.9%），組間差異有統計學意義（P＜0.001）。 結論 地震給人們的精神創傷較重，至今仍然普遍存在，并對患者的就醫活動產生影響。提示在北川縣院前急救工作中需要考慮患者的精神傷害情況。
【摘要】 目的 分析地市級急救中心院前急救中損傷患者臨床特點，科學地指導院前急救診斷處置及急診外科資源配置。 方法 回顧性分析2009年1-12月份自貢市急救中心出診的全部有效病例中損傷患者出診資料，分析其疾病譜、季節、月份、時刻分布特點。 結果 全年院前急救損傷患者共1 922例，排名前5位的分別為:頭部損傷，涉及身體多個部位的損傷，膝和小腿損傷，腹部、背、腰椎和骨盆損傷，髖和大腿損傷，所有分類構成比男性均多于女性；損傷季節分布以冬季較多（Plt;0.05）；分布以1、11、12月份為多；時刻分布以凌晨0:00~6:00為出診最少時段。 結論 國際疾病分類（ICD-10）為規范院前急救疾病譜提供參考，根據損傷類疾病譜可確定急診外科工作及發展重心，依據季節、月份及時刻分布特點能指導急救資源合理配置。【Abstract】 Objective To provide scientific guidance of assistances for patients sustaining injuries and of effective resource allocation of emergency surgery by analyzing the pre-hospital features of injuries in urgent rescue centers at the local or city level. Methods All cases of injuries in pre-hospital emergency care during the year of 2009 were studied. The spectrum of diseases, and the seasons, the months, and the time points of the diseases were analyzed. Results There were totally 1 922 patients of pre-hospital emergency care in the whole year. Based on the International Classification of Diseases 10th Revision (ICD-10), top five classifications were injuries to the head, injuries involving multiple body regions, injuries to the knee and lower leg, injuries to the abdomen, lower back, lumbar spine and pelvis, and injuries to the hip and thigh. For all kinds of injuries, the number of male patients was more than that of the female. The cases in winter were more than those in other seasons (Plt;0.05). The cases in January, November and December were more than those in other months. The cases between 0:00 am and 6:00 am were less than those at other time points. Conclusion ICD-10 could provide reference for standardizing the spectrum of diseases in pre-hospital care. The focus of emergency surgery may be guided by the spectrum of injuries. The features of the season, the month, and time point of diseases can offer practical help for resource allocation in pre-hospital care.
目的:探討使用院前指數(Prehospital Index, PHI)及格拉斯哥昏迷評分(Glasgow Coma Score, GCS)兩種創傷評分法對院前急救中急性酒精中毒合并外傷性顱內出血患者的評估價值。方法: 納入68例院前急救中酒精中毒合并頭外傷患者,院前均進行PHI及GCS兩種創傷評分,隨訪至出院,以頭部CT掃描及隨訪結果作為標準以判斷患者是否伴有顱內出血。計算兩種創傷評分的敏感度、特異度、陽性似然比、陰性似然比、陽性預測值、陰性預測值及Youden指數,并作出受試者工作特征曲線(ROC曲線),以正態離差值Z檢驗兩種評分法ROC曲線下面積的差異。 結果: 院前指數以6分作為診斷界值,敏感度為94.7%,特異度為71.4%;格拉斯哥昏迷評分以9分作為診斷界值,敏感度為98.8%,特異度為30.6%,PHI及GCS的ROC曲線下面積分別是0.881和0.678,其差異有統計學意義。結論: 在對急性酒精中毒合并頭外傷患者是否伴有顱內出血的院前評估中,院前指數較格拉斯哥昏迷評分更有價值。
目的:通過分析2007年自貢市急救中心院前急救反應能力，探討其影響制約因素及解決方法。方法：回顧性分析2007年1～12月份自貢市急救中心院前出診的全部有效病例呼救時間、出車時間、到達現場時間及出診距離，計算出車準備時間、車輛行駛速度、應急反應時間、急救半徑。結果：全年院前出診共3336例，出車準備時間（2.06±0.93） min，車輛平均行駛速度32.17 km/h，應急反應時間（12.51±10.87） min，急救半徑（5.60±5.35） km。結論：我市急救中心目前取得一定成績，需采取多種措施進一步提高急救反應能力。