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中华卫生应急电子杂志 ›› 2017, Vol. 03 ›› Issue (03) : 152 -156. doi: 10.3877/cma.j.issn.2095-9133.2017.03.006

所属专题: 文献

论著

中国与英国两家医院对急性创伤患者早期镇痛治疗比较
邹秋平1,(), Paul Ransom2,(), Samuel Freeman2, 曾汉强1, 陈文正1, 李剑强1   
  1. 1. 523059 东莞市人民医院急诊外科
    2. 英国布赖顿和苏塞克斯大学医院急诊科
  • 收稿日期:2017-04-04 出版日期:2017-06-18
  • 通信作者: 邹秋平, Paul Ransom

Comparison of pain relief for acute traumatic patients at early stage between two hospitals in China and the UK

Qiuping Zou1,(), Paul Ransom2,(), Samuel Freeman2, Hanqiang Zeng1, Wenzheng Chen1, Jianqiang Li1   

  1. 1. Emergency Surgery, Dongguan People's Hospital, Dongguan 523059, China
    2. Emergency Department, Brighton and Sussex University Hospital Accident and the UK
  • Received:2017-04-04 Published:2017-06-18
  • Corresponding author: Qiuping Zou, Paul Ransom
  • About author:
    Corresponding author: ZouQiuping, Email:
    Paul Ransom, Email:
引用本文:

邹秋平, Paul Ransom, Samuel Freeman, 曾汉强, 陈文正, 李剑强. 中国与英国两家医院对急性创伤患者早期镇痛治疗比较[J/OL]. 中华卫生应急电子杂志, 2017, 03(03): 152-156.

Qiuping Zou, Paul Ransom, Samuel Freeman, Hanqiang Zeng, Wenzheng Chen, Jianqiang Li. Comparison of pain relief for acute traumatic patients at early stage between two hospitals in China and the UK[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2017, 03(03): 152-156.

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 and tramadol Rotundine, celecoxib, Lo Finn Den. After analgesia, pain index of patients in Brighton and Sussex University hospital was significantly lower than that ofDongguan 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.

表1 两家医院患者一般情况比较及GCS、ISS评分比较
表2 损伤部位分布情况
表3 布赖顿和苏赛克斯大学医院院前和院内止痛药物使用情况(例)
表4 东莞市人民医院院前院内止痛药使用情况(例)
表5 患者疼痛评分比较(±s)
表6 创伤患者结局情况(例)
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Ahmadi A, Bazargan-Hejazi S, Heidari Zadie Z, et al.Pain management in trauma: A review study[J]. J Inj Violence Res, 2016, 8(2): 89-98.
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Spilman SK, Lechtenberg GT, Hahn KD, et al.Is pain really undertreated? Challenges of addressing pain in trauma patients during prehospital transport and trauma resuscitation[J]. Injury, 2016, 47(9): 2018-2024.
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