骨盆及多发骨折患者治疗的多学科协作急救模式
Multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures.
作者信息
Han Yun, Peng Ganggang, Liu Lijun, Xie Xiaohua
机构信息
Yun Han, Department of Traumatic Orthopedics, Shenzhen Second People's Hospital, 3002 Sungang West Road, Shenzhen, 518030 Guangdong Province P.R. China.
Ganggang Peng, Department of Emergency, Shenzhen Second People's Hospital, 3002 Sungang West Road, Shenzhen, 518030 Guangdong Province P.R. China.
出版信息
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):560-564. doi: 10.12669/pjms.38.3.5014.
OBJECTIVES
To retrospectively evaluate a multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures in the emergency department.
METHODS
The records of patients with pelvic fractures complicated with multiple fractures treated in our hospital from February 2020 to April 2021 were selected, of which 34 patients received conventional trauma first aid mode control group) and 34 patients received multidisciplinary joint first aid mode (study group). We compared pelvic function (Majeed functional score) and fracture reduction outcomes, as well as serum inflammatory factor levels and complication rates after treatment between the two groups.
RESULTS
The Majeed score in the study group (90. 15 ± 6.83) was higher than that in the control group (75. 47 ± 5.35), and the differences were statistically significant(P<0.05). The value for combined excellent and good rates of fracture reduction in the study group (85.29%, 29/34) was significantly higher than that in the control group (58.82%, 20/34), and the difference was statistically significant(P<0.05). We found similar levels of TNF-a and IL-6 between the two groups at admission(P>0.05); however, the serum levels of TNF-a and IL-6 in the study group were lower than those in the control group on the fifth day after admission, and the difference was statistically significant (P<0.05 or P<0.01). The incidence of complications in the study group (17.64%, 6/34) was significantly lower than that in the control group (61.76%, 21/34), the difference was statistically significant(P<0.05).
CONCLUSION
The multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures can effectively shorten the treatment time, increase the excellent functional rehabilitation rate, inhibit the release of inflammatory factors, and reduce the incidence of complications (such as infections), when compared to the conventional trauma emergency system.
目的
回顾性评估急诊科多学科协作的急救模式在骨盆及多发骨折患者治疗中的应用效果。
方法
选取2020年2月至2021年4月在我院治疗的骨盆骨折合并多发骨折患者的病历资料，其中34例患者接受传统创伤急救模式（对照组），34例患者接受多学科联合急救模式（研究组）。比较两组患者的骨盆功能（马吉德功能评分）、骨折复位效果、治疗后血清炎症因子水平及并发症发生率。
结果
研究组的马吉德评分（90.15±6.83）高于对照组（75.47±5.35），差异有统计学意义（P<0.05）。研究组骨折复位优良率（85.29%，29/34）显著高于对照组（58.82%，20/34），差异有统计学意义（P<0.05）。两组患者入院时肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平相似（P>0.05）；然而，研究组患者入院后第5天的血清TNF-α和IL-6水平低于对照组，差异有统计学意义（P<0.05或P<0.01）。研究组并发症发生率（17.64%，6/34）显著低于对照组（61.76%，21/34），差异有统计学意义（P<0.05）。
结论
与传统创伤急救系统相比，多学科协作的急救模式在骨盆及多发骨折患者治疗中可有效缩短治疗时间，提高功能康复优良率，抑制炎症因子释放，降低并发症（如感染）发生率。
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