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高级创伤生命支持研究:诊断与治疗程序的质量

Advanced trauma life support study: quality of diagnostic and therapeutic procedures.

作者信息

van Olden Ger D J, Meeuwis J Dik, Bolhuis Hugo W, Boxma Han, Goris R Jan A

机构信息

Department of General Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

J Trauma. 2004 Aug;57(2):381-4. doi: 10.1097/01.ta.0000096645.13484.e6.

Abstract

BACKGROUND

The introduction of the ATLS course in The Netherlands in 1995 provided for an opportunity to compare data of trauma patients between a pre-ATLS and a post-ATLS period.

MATERIALS AND METHODS

Over a 3-year period (May 1996 - September 1997 pre ATLS; December 1997-April 1999 post ATLS) 63 trauma patients with an AIS-ISS > or = 16 (n = 31, pre-ATLS and n = 32, post-ATLS) were prospectively studied in two community residency training (ACS Level III) hospitals. All diagnostic and therapeutic procedures were recorded by a video-camera and evaluated by a neutral faculty of six experienced ATLS trained specialists.

RESULTS

Ten out of 14 interventions were performed qualitatively better in the post-ATLS group, while also the overall score was highly significantly better (4.2 pre-ATLS and 5.8 post-ATLS, p < 0.0001).

CONCLUSION

Using the opinion of an expert team, this study identified a significantly lower number of patients with inadequate management.

摘要

背景

1995年荷兰引入了高级创伤生命支持(ATLS)课程,这为比较ATLS实施前后创伤患者的数据提供了契机。

材料与方法

在三年期间(1996年5月 - 1997年9月为ATLS实施前;1997年12月 - 1999年4月为ATLS实施后),在两家社区住院医师培训(美国外科医师学会三级)医院对63例创伤严重度评分(AIS)-损伤严重度评分(ISS)≥16的创伤患者进行了前瞻性研究(ATLS实施前31例,ATLS实施后32例)。所有诊断和治疗程序均用摄像机记录,并由六位经验丰富的接受过ATLS培训的专家组成的中立团队进行评估。

结果

14项干预措施中有10项在ATLS实施后组的执行质量更好,而且总体评分也显著更高(ATLS实施前为4.2,ATLS实施后为5.8,p < 0.0001)。

结论

通过专家团队的意见,本研究发现管理不当的患者数量显著减少。

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