Prokop A, Hötte H, Krüger K, Rehm K E, Isenberg J, Schiffer G
Fachbereich Unfallmedizin und Sozialversicherung, Fachhochschule Bonn-Rhein-Sieg, Hennef.
Unfallchirurg. 2006 Jul;109(7):545-50. doi: 10.1007/s00113-006-1086-5.
In severely injured patients, diagnostic procedures should be as brief as possible. With the use of spiral CT technology, the time required for diagnosis is minimized.
Do severely injured patients benefit when primary diagnostic examinations are completed in less than 30 min? How much time is required for primary emergency department (ED) care and how much in the CT scanner?
Between 31 July 2001 and 31 December 2003, severely injured patients with ISS scores over 16 underwent total body spiral CT scans (Siemens Somatom Volume Zoom Multislice CT) after initial ultrasonography. One hundred patients (M:F=25:75) with an average age of 42 years (range: 3-81 years) were evaluated retrospectively. The average ISS score was 32.8+/-12 points (range: 17-75 points).
The average time in the ED, prior to CT, was 33+/-14 min. The CT scans lasted 16+/-5 min and the total diagnostic time was 48+/-14 min. Fifty percent of patients were taken immediately to the operating room. The mortality rate in hospital was 13%. The average hospital stay was 30 days, with an average ICU stay of 10 days.
The shorter the time spent in the ED, the shorter the stays in ICU and in total hospitalization were, regardless of injury severity. With structured management and shortening of diagnostic time with spiral CT, the time in the ED was decreased from 85 to 48 min.
在重伤患者中，诊断程序应尽可能简短。使用螺旋CT技术可将诊断所需时间减至最短。
对重伤患者而言，在30分钟内完成初步诊断检查是否有益？急诊室（ED）的初步护理需要多长时间，在CT扫描仪上又需要多长时间？
在2001年7月31日至2003年12月31日期间，初始超声检查后，损伤严重度评分（ISS）超过16分的重伤患者接受了全身螺旋CT扫描（西门子Somatom Volume Zoom多层CT）。对100例患者（男:女 = 25:75）进行了回顾性评估，平均年龄42岁（范围：3 - 81岁）。平均ISS评分为32.8±12分（范围：17 - 75分）。
在进行CT扫描前，患者在急诊室的平均时间为33±14分钟。CT扫描持续16±5分钟，总诊断时间为48±14分钟。50%的患者被立即送往手术室。医院死亡率为13%。平均住院时间为30天，平均重症监护病房（ICU）停留时间为10天。
无论损伤严重程度如何，在急诊室花费的时间越短，在ICU和总住院时间就越短。通过结构化管理和使用螺旋CT缩短诊断时间，急诊室停留时间从85分钟降至48分钟。
