Study On Treatment Effect Of Acute Traumatic Diseases In Jiangxi After Establish Emergency Center Under The Leading Of Integrated Medicine

Objective:By comparing and analyzing the effect of trauma patients before and after the establishment of trauma emergency center in our hospital,we explored the defects in the process of trauma treatment,and provided references for improving the trauma treatment system and optimization process,and providing theoretical support for the establishment and promotion of emergency trauma center.Methods:The clinical data of patients hospitalized for acute trauma and treated in emergency room in First Affiliated Hospital of Nanchang University from February2018 to February 2020 were retrospectively analyzed.With the establishment of trauma emergency center as the cut-off point(February 2019),the patients were divided into the trauma center pre-establishment group(pre-establishment group)and the trauma center post-establishment group(post-establishment group).1.Observe the gender,age,month of injury,type of trauma,length of stay,trauma severity score(ISS score),APACHE II score,Glasgow coma score(GCS score)and the number of deaths of patients hospitalized for acute trauma in the two groups.2.Observe the age,sex,treatment time,type of trauma,number of patients requiring emergency operation,number of patients with severe injury with ISS>16 points,number of patients undergoing ventilator-assisted ventilation with endotracheal intubation,number of patients requiring immediate blood transfusion,preparation time for ventilator-assisted ventilation with endotracheal intubation,preparation time for transfusion,preparation for imaging examination in the two groups.Time,preoperative preparation time and the number of deaths in the emergency room.3.Subgroup analysis was conducted for inpatients and emergency room patients with abdominal trauma as the main diagnosis,and gender,age,ISS score,type of abdominal trauma,type of operation and mortality were observed in the two groups.SPSS 20.0 statistical software was used for analysis.Measurement data were expressed as mean standard deviation(x+s).Independent sample t-test was used for comparison between groups,and X~2test was used for counting data.P<0.05 was statistically significant.Results:1.According to the inclusion criteria,there were 6007 hospitalized patients due to acute trauma in the pre-establishment group and 6227 hospitalized patients due to acute trauma in the post-establishment group.There were no significant differences in gender,age,month of injury,type of trauma and ISS score between the two groups.Subgroup analysis was conducted on hospitalized patients who entered the ICU for treatment.521 patients in the former group entered the ICU for treatment,and 607 patients in the latter group entered the ICU for treatment.There were no significant differences in gender,age,length of stay,ISS score APACHE II score,GCS score and ISS score between the two groups,but the mortality rate of patients who entered the ICU after creation was lower than that before creation,and the difference was statistically significant(P<0.05).2.According to the inclusion criteria,there were 1046 patients in the pre establishment group and 1128 patients in the post establishment group.There were no significant differences in age,gender,type of trauma,number of patients requiring emergency surgery,severe injury patients with ISS>16,patients with tracheal intubation ventilator assisted ventilation,and patients requiring immediate blood transfusion between the two groups.However,the treatment time in the rescue room,preparation time for ventilation with endotracheal intubation ventilator,blood transfusion preparation time and imaging were not significantly different between the two groups The examination preparation time,preoperative preparation time and the number of deaths in the rescue room were lower than those in the pre establishment group,the difference was statistically significant,P<0.05.3.Among the patients hospitalized due to acute trauma,there were 197 patients hospitalized due to abdominal trauma in the pre-establishment group and 242 patients hospitalized due to abdominal trauma in the post-establishment group.There was no significant difference in gender,age,ISS score,type of abdominal trauma and type of operation between the two groups,but the mortality rate of the patients hospitalized due to abdominal trauma in the post-establishment group was lower than that in the pre-establishment Meaning,P<0.05.Among the patients treated in the emergency room,176 patients in the pre-creation group were treated in the emergency room due to abdominal trauma,and 196 patients in the post-creation group were treated in the emergency room due to abdominal trauma.There was no significant difference in gender,age and ISS score between the two groups,but the mortality rate of patients treated in the emergency room due to abdominal trauma in the post-creation group was lower than that in the pre-creation group,with significant difference,P<0.05.Conclusion:1.After the establishment of trauma emergency center,the rapid linkage of clinical disciplines and relevant departments of medical technology,the centralized treatment of trauma patients,and the formation of a rapid comprehensive trauma emergency system of prehospital first aid-trauma emergency center-operating room-trauma ICU-trauma surgery ward can reduce the mortality of patients hospitalized in ICU due to trauma.2.After the establishment of trauma emergency center,the establishment of pre hospital emergency department,the standardized professional training of personnel,the formation of pre hospital and in hospital treatment integrated treatment system,the establishment of multi-disciplinary professional rescue team in the rescue room,and the establishment of rapid linkage mechanism between clinical disciplines and medical technology auxiliary departments have shortened the preparation time of endotracheal intubation ventilator assisted ventilation,blood transfusion preparation and impact Imaging examination preparation time and preoperative preparation time and can effectively reduce the mortality of patients in the rescue room.3.After the establishment of trauma emergency center,the implementation of trauma first aid green channel,the full responsibility of trauma emergency doctors,and the establishment of professional treatment team of abdominal trauma effectively reduced the mortality of hospitalized patients and patients treated in the emergency room due to abdominal trauma.