急诊绿色通道在创伤性膈疝中的应用体会
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摘要
目的阐述急诊绿色通道在创伤性膈疝中的应用体会。方法回顾性分析2017年5月至2018年5月,江苏省人民医院收治的25例创伤性膈疝患者的临床资料,均采用急诊创伤绿色通道进行抢救。记录患者手术情况、治疗结果及术后并发症情况。结果 25例患者到达医院立即启动创伤通,所有创伤通道人员到位时间(5±5.5)min,到达医院至手术时间(60.7±6.2)min。23例入院后行急诊手术,另外2例均于入院后第2天手术。并发症发生率为8.70%,死亡率为8.00%,治疗成功率为92.0%。结论急诊创伤绿色通道的设立可大大缩短受伤至手术时间,以最迅速的方式使创伤性膈疝患者得到及时救治,提倡更多的医院建立"急诊创伤绿色通道",使更多的患者在最短的时间内接受有效的治疗。
Objective To explain the application experience of emergency green channel in traumatic diaphragmatic hernia. Methods The clinical data of 25 patients with traumatic diaphragmatic hernia admitted to Jiangsu provincial people's hospital from May 2017 to May 2018 were retrospectively analyzed. All patients were rescued by emergency green channel. The operation situation, treatment results and postoperative complications were recorded. Results The average pre-hospital emergency time was(23.6±5.5) minutes in 25 patients, and the time from injury to surgery was(72.7±6.2) minutes. 23 patients underwent emergency surgery after admission, and the other 2 patients underwent surgery on the 2 nd day after admission. The complication rate was 8.70%, the mortality rate was 8.00%, and the treatment success rate was 92.0%. Conclusion The establishment of the emergency green channel can greatly shorten the time from injury to surgery. The patients with traumatic diaphragmatic hernia are treated promptly in the most rapid way, and advocate more hospitals to establish an "emergency green channel" so that more patients can receive effective treatment in the shortest time.
Objective To explain the application experience of emergency green channel in traumatic diaphragmatic hernia. Methods The clinical data of 25 patients with traumatic diaphragmatic hernia admitted to Jiangsu provincial people's hospital from May 2017 to May 2018 were retrospectively analyzed. All patients were rescued by emergency green channel. The operation situation, treatment results and postoperative complications were recorded. Results The average pre-hospital emergency time was(23.6±5.5) minutes in 25 patients, and the time from injury to surgery was(72.7±6.2) minutes. 23 patients underwent emergency surgery after admission, and the other 2 patients underwent surgery on the 2 nd day after admission. The complication rate was 8.70%, the mortality rate was 8.00%, and the treatment success rate was 92.0%. Conclusion The establishment of the emergency green channel can greatly shorten the time from injury to surgery. The patients with traumatic diaphragmatic hernia are treated promptly in the most rapid way, and advocate more hospitals to establish an "emergency green channel" so that more patients can receive effective treatment in the shortest time.
引文
[1]Fangbiao Z,Chunhui Z,Chun Z,et al.Thoracotomy for Traumatic Diaphragmatic Hernia[J].Indian J Surg,2016,78(5):371-374.
[2]张培信,石秀娟.创伤性膈疝20例临床分析[J].中国实用医药,2017,12(33):139-140.
[3]张智慧,邰沁文,吐尔洪江·吐逊,等.腹腔镜治疗陈旧性创伤性膈疝的初步探讨[J].中国微创外科杂志,2015,15(2):143-145.
[4]何松林,刘慧,赖朝文.创伤性膈疝早期诊断及临床治疗19例体会[J].中国实用外科杂志,2014,34(5):449-449.
[5]李亮.实用腹股沟疝外科学[M].西安:世界图书出版西安有限公司,2014:129-130.
[6]Silva GP,Cataneo DC,Cataneo AJM,et al.Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia.Systematic review and proportional methanalysis[J].Acta Cir Bras,2018,33(1):49-66.
[7]齐书山,田锋.创伤性膈疝的早期诊断及误诊原因分析[J].中国医刊,2015,50(8):57-60.
[8]朱文煜,王颜,舒刚,等.多发肋骨骨折并发创伤性膈疝患者的微创手术效果研究[J].中国内镜杂志,2016,22(8):74-78.
[9]钟京,易云峰,陈检明,等.胸腔镜在多发肋骨骨折合并创伤性膈疝治疗中的应用[J].中华创伤杂志,2016,32(1):78-79.
[10]张智慧,马海长,马尔旦·马合木提,等.创伤性膈疝的诊断与治疗[J].中国现代普通外科进展,2016,19(1):75-78.
[11]黄永祥,吕荣伟.创伤性膈疝早期诊断与治疗[J].浙江创伤外科,2015,20(3):515-516.
[12]张庆荣,毛春节,曹云云,等.急诊绿色通道在急性心肌梗死患者抢救中的应用[J].解放军护理杂志,2015,32(23):67-69.
[13]王锦泓,胡星,梁昱,等.畅通急诊绿色通道的思考与探索[J].中国现代医学杂志,2014,24(22):108-110.
[14]庄君灿,黄奇花,吕伟垣,等.急诊绿色通道对颅脑外伤患者临床疗效的影响[J].实用医学杂志,2015,31(3):433-436.
[2]张培信,石秀娟.创伤性膈疝20例临床分析[J].中国实用医药,2017,12(33):139-140.
[3]张智慧,邰沁文,吐尔洪江·吐逊,等.腹腔镜治疗陈旧性创伤性膈疝的初步探讨[J].中国微创外科杂志,2015,15(2):143-145.
[4]何松林,刘慧,赖朝文.创伤性膈疝早期诊断及临床治疗19例体会[J].中国实用外科杂志,2014,34(5):449-449.
[5]李亮.实用腹股沟疝外科学[M].西安:世界图书出版西安有限公司,2014:129-130.
[6]Silva GP,Cataneo DC,Cataneo AJM,et al.Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia.Systematic review and proportional methanalysis[J].Acta Cir Bras,2018,33(1):49-66.
[7]齐书山,田锋.创伤性膈疝的早期诊断及误诊原因分析[J].中国医刊,2015,50(8):57-60.
[8]朱文煜,王颜,舒刚,等.多发肋骨骨折并发创伤性膈疝患者的微创手术效果研究[J].中国内镜杂志,2016,22(8):74-78.
[9]钟京,易云峰,陈检明,等.胸腔镜在多发肋骨骨折合并创伤性膈疝治疗中的应用[J].中华创伤杂志,2016,32(1):78-79.
[10]张智慧,马海长,马尔旦·马合木提,等.创伤性膈疝的诊断与治疗[J].中国现代普通外科进展,2016,19(1):75-78.
[11]黄永祥,吕荣伟.创伤性膈疝早期诊断与治疗[J].浙江创伤外科,2015,20(3):515-516.
[12]张庆荣,毛春节,曹云云,等.急诊绿色通道在急性心肌梗死患者抢救中的应用[J].解放军护理杂志,2015,32(23):67-69.
[13]王锦泓,胡星,梁昱,等.畅通急诊绿色通道的思考与探索[J].中国现代医学杂志,2014,24(22):108-110.
[14]庄君灿,黄奇花,吕伟垣,等.急诊绿色通道对颅脑外伤患者临床疗效的影响[J].实用医学杂志,2015,31(3):433-436.