Graf M, Demartines N, Harder F, Scheidegger D
Departemente Chirurgie und Anästhesie der Universität, Kantonsspital Basel.
Helv Chir Acta. 1993 Mar;59(4):649-53.
We analyzed the influence of initial intensive care at the accident site performed by an emergency physician and followed by helicopter transport on the course during hospital stay in patients with multiple trauma. We therefore compared the dates of 107 patients transported by the swiss air rescue (REGA) and an emergency physician with 131 patients transported by an ambulance and paramedic staff. By similar case material the REGA-patients showed a higher injury severity grade. Mortality of the REGA-patients was significantly higher (21%) than of the ambulance-patients (10%), but length of stay was significantly shorter and morbidity identical. We suspect, that the higher mortality of the REGA-patients is explained by the large number of surgically nontreatable severe traumas. None of the REGA-patients arrived at hospital with circulatory insufficiency whereas 4 of the ambulance-patients were in state of shock. We assume that first of all primary treatment of the scene of injury by an emergency physician and eventually also transport by helicopter have a positive effect on the course of patients with multiple trauma during hospital stay.
我们分析了由急诊医生在事故现场进行初始重症监护并随后通过直升机转运，对多发伤患者住院期间病程的影响。因此，我们将瑞士空中救援（REGA）和一名急诊医生转运的107例患者与由救护车和护理人员转运的131例患者的情况进行了比较。在类似病例资料中，REGA组患者的损伤严重程度分级更高。REGA组患者的死亡率（21%）显著高于救护车转运组患者（10%），但住院时间显著更短，发病率相同。我们怀疑，REGA组患者较高的死亡率是由大量手术无法治疗的严重创伤所致。REGA组患者均无循环功能不全到达医院，而救护车转运组有4例患者处于休克状态。我们认为，首先由急诊医生在受伤现场进行的初步治疗以及最终通过直升机转运，对多发伤患者住院期间的病程有积极影响。
