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目的探讨集束化干预对急诊外伤性危重患者感染情况及预后的影响。方法选取2015年1月-2016年10月间本院收治的急诊外伤性危重患者144例,随机分为研究组和对照组各72例。对照组患者在药物或手术治疗基础上给予常规照护;研究组患者在此基础上给予集束化干预。观察两组患者干预后伤口感染和呼吸道感染情况、住院时间、机械通气时间;比较两组患者干预前后血清炎性指标变化情况。结果研究组患者总感染率(8.33%)明显低于对照组(30.56%),差异有统计学意义(P<0.05);其中研究组伤口感染率和呼吸道感染率均低于对照组,差异有统计学意义(P<0.05)。研究组患者住院时间〔(23.76±8.20)d〕明显短于对照组〔(36.52±9.57)d〕,机械通气时间〔(6.23±0.85)d〕也明显短于对照组〔(11.58±1.62)d〕,差异有统计学意义(P<0.01)。干预前研究组和对照组血清CRP和WBC之间差异无统计学意义(P>0.05);干预后研究组血清CRP〔(13.56±6.41)mg/L〕和WBC〔(8.62±1.20)×109/L〕均明显低于〔(43.72±10.95)mg/L〕、〔(15.23±5.96)×109/L〕对照组,差异有显著统计学意义(P<0.01)。结论集束化干预可有效降低急诊外伤性危重患者感染率,缩短恢复时间,控制炎性指标水平,值得在临床中推广应用。
Objective To explore the effect of cluster intervention on the infection and prognosis of emergency traumatic critically ill patients. Methods From January 2015 to October 2016, 144 cases of emergency traumatic critically ill patients admitted to our hospital were randomly divided into study group and control group, with 72 cases in each group. Patients in the control group were given routine care based on the drug or surgical treatment; the study group received intensive intervention on the basis of this. The wound infections and respiratory infections, hospitalization time and mechanical ventilation time were observed after intervention in both groups. The changes of serum inflammatory markers before and after intervention were compared between the two groups. Results The total infection rate (8.33%) in study group was significantly lower than that in control group (30.56%), the difference was statistically significant (P <0.05). The wound infection rate and respiratory infection rate in study group were lower than that in control group Statistical significance (P <0.05). The length of hospital stay (23.76 ± 8.20) days in the study group was significantly shorter than that in the control group (36.52 ± 9.57 days) and the duration of mechanical ventilation (6.23 ± 0.85 days) was significantly shorter than that in the control group (11.58 ± 1.62) d], the difference was statistically significant (P <0.01). There were no significant differences in serum CRP and WBC between study group and control group before intervention (P> 0.05). After intervention, the levels of serum CRP (13.56 ± 6.41) mg / L and WBC 〔(8.62 ± 1.20) × 109 / L] were significantly lower than [(43.72 ± 10.95) mg / L〕 and 〔(15.23 ± 5.96) × 109 / L〕 in the control group, the difference was statistically significant (P <0.01). Conclusion Aggregation intervention can effectively reduce the infection rate of emergency traumatic critically ill patients, shorten the recovery time and control the level of inflammatory markers, which is worth popularizing in clinic.