作　　者： (邹秋平）; (曾汉强）; (陈文正）; (李剑强）;

机构地区： 东莞市人民医院急诊外科

出　　处： 《中华卫生应急电子杂志》 2017年第3期152-156,共5页

摘　　要： 目的比较中国和英国对创伤患者早期镇痛治疗的方法和差异,以利于提高创伤患者的就诊体验及提高创伤的救治水平。方法回顾性收集英国布赖顿和苏塞克斯大学医院急诊科和东莞市人民医院急诊科2016年4月至2016年6月初步救治需要进抢救室的创伤患者的资料,比较两个不同医院急诊科使用止痛药物种类及比例、患者的救治过程中的疼痛评分、抢救成功率。结果两家医院的患者在年龄、性别比例、致伤原因、到达急诊科时GCS评分差异有统计学意义(P<0.05),但ISS评分差异无统计学意义(P>0.05)。布赖顿和苏赛克斯大学医院急诊创伤患者以四肢和骨盆损伤为主,东莞市人民医院急诊患者则以头颈部损伤为主。布赖顿和苏赛克斯大学医院急诊创伤患者院前及院内止痛药物使用比例高,常用止痛药物为扑热息痛、吗啡、氯胺酮、芬太尼;东莞市人民医院急诊创伤患者使用止痛药物比例低,院前未使用止痛药物,院内较常用止痛药物为曲马多、地佐辛、罗痛定、塞来昔布、洛芬待因。经过镇痛后,英国患者(布赖顿和苏赛克斯大学医院疼痛评分由5.37下降至2.68)疼痛评分下降较中国患者更为显著(东莞市人民医院疼痛评分由4.66下降至3.72)。两家医院的急诊患者病死率比较接近,布赖顿和苏赛克斯大学医院为3.5%,东莞市人民医院为3.6%。结论对创伤患者及时进行镇痛能明显降低患者的疼痛评分,改善患者的就医体验,更好体现对患者的人文关怀。 Objective To compare pain relief treatments for traumatic patients at the early stage between two hospitals in China and the UK,and to improve the experience of patients and treatment level.Methods Review of data collected from emergency departments of Britain's Brighton and Sussex University hospital and Dongguan People's Hospital from April 2016 to June 2016 at the beginning of trauma patient treatment need to step into the resuscitation room in accident and emergency department,and to compare of the type and proportion pain medications,the pain score in trement,the success rate of rescue in two hospitals. Results There was no significant difference in ISS score between the two hospitals( P > 0. 05),but there were significant differences in age,gender ratio,cause of injury,and GCS score in emergency department in two hospitals( P < 0. 05). Trauma patients with limbs and pelvic injury was common in Brighton and Sussex University hospital emergency department,and patients with head and neck injuries was common in Dongguan People's Hospital emergency department. A high proportion of using analgesic drugs in pre-hospital and in-hospital trauma patients was observed in emergency department of Brighton and Sussex University hospital,and common analgesic drugs were paracetamol,morphine,ketamine and fentanyl. A low proportion of using analgesic drugs in in pre-hospital and in-hospital trauma patients was observed in emergency department of Dongguan People's Hospital,and common analgesic drugs were dezocine andtramadol Rotundine,celecoxib,Lo Finn Den. After analgesia,pain index of patients in Brighton and Sussex University hospital was significantly lower than that of Dongguan People's Hospital. Conclusion For patients with trauma Analgesia for trauma patients in a timely manner can significantly reduce the pain score of patients,improve the patient's medical experience,reflect the humanistic care of patients.

关 键 词： 创伤 镇痛 损伤严重程度评分