【作者】 李梅；

【导师】 赵会民；

【作者基本信息】 广西医科大学 ， 临床医学（专业学位）， 2020， 硕士

【摘要】 目的:了解某乡镇中心卫生院院前急救特点及转诊情况。方法:收集2018年9月至2019年8月某乡镇中心卫生院院前急救的性别、年龄、初步诊断、急救半径、呼救时间、急救干预情况、死亡情况及转诊等资料,使用EXCEL进行数据录入和整理,并进行二次核对。运用SPSS21.0统计软件对数据进行统计分析。根据是否转上级医院,分为转诊组和非转诊组,两组间构成比之间的差异性比较采用卡方检验。以P<0.05为差异具有统计学意义。结果:(1)车载、药品及人员情况:救护车2辆,车上均有担架、氧气罐、便捷式呼吸气囊、血糖仪、急救药品。人员配置:妇产科执业医师4人,均为女性,年龄在27岁至41岁之间;全科医师8名,男性6人,女性2人,年龄在24岁至33岁;13名护士均为女性,年龄在22岁至35岁;以及专职男性司机2名。(2)性别年龄分布:院前急救患者393人次,男性191例,女性202例,以30～60年龄段为多,平均年龄(45.69±24.24)岁。(3)呼救时间、急救半径分布:呼救高峰为9:00～15:00,急救半径(5.02±5.19)km,寒冷季节院前急救患者数量较多。(4)疾病谱:院前急救前4位疾病为创伤、妇产科疾病、脑血管意外、呼吸循环系统疾病。(5)应用最多的急救技术是静脉穿刺术63.4%、吸氧术27.0%。(6)转诊情况:转上级医院最多的是创伤、妇产科疾病、脑血管意外。转诊率达78.1%,转诊组中吸氧术,静脉穿刺术使用率高,与非转诊组对比,差异有统计学意义,部分患者经门诊或住院治疗后转诊。(7)死亡病例情况:死亡6例,脑血管意外、肿瘤晚期、猝死各1例。死亡地点:3例在现场死亡,3例在转运途中死亡。结论:急救转诊和初步诊疗后转诊是乡镇卫生院重要的工作内容,其服务疾病谱广泛,全科医师急救知识有待加强,相关的医疗器械设备及药品也期待得到进一步补充完善。更多还原

【Abstract】 Objective :To explore the referral and pre-hospital rescue form a township hospital.Methods :Collect the data of sex,age,preliminary diagnosis,first aid radius,call time,emergency intervention,death and referral of pre-hospital first aid in a township central hospital from September 2018 to August 2019,use EXCEL to input and collate the data,and carry out secondary check.statistical analysis of data using SPSS21.0 statistical software.According to whether transfer to the higher hospital,it was divided into referral group and non-referral group.P <0.05 was statistically significant.Results :(1)Vehicle,medicine and personnel situation:2 ambulances,the vehicle has stretcher,oxygen tank,convenient breathing air bag,blood sugar meter,drugs.Staff :4 obstetricians and gynecologists,all female,between the ages of 27 and 41;8 general practitioners,6 males,2 females,between the ages of24 and 33;13 nurses,all female,between the ages of 22 and 35,and 2 full-time male drivers.(2)Sex age distribution :393 pre-hospital first aid patients,191 males and 202 females,more than 30~60 years old,with an average age(45.69±24.24)years.(3)Call time,first aid radius distribution: call for help peak at 9:00~15:00,first aid radius(5.02±5.19)km,cold season pre-hospital first aid patients are more.(4)Disease spectrum: the the top four diseases were trauma,obstetrics and gynecological diseases,cerebrovascular accident,respiratory and circulatory diseases.(5)The most used first aid techniques are venipuncture and oxygen inhalation,respectively account for 63.4%and27.0%.(6)Referrals:The most frequently transfer to higher hospitals are trauma,obstetrics and gynecological diseases and cerebrovascular accidents.The rate of referral was78.1%.In the referral group,oxygenation,venipuncture,higher utilization rate,the difference was statistically significant compared with non-referral group.Some patients referral after outpatient or hospitalization treatment.(7)Cases of death :6cases of death,cerebrovascular accident,advanced tumor,sudden death 1case each.Place of death :3 died on site and 3 died in transit.Conclusion : First aid referral and initial diagnosis and treatment referral are important work in township hospital,their service disease spectrum is wide,first aid knowledge of general practitioners hope to be strengthened,and the relevant medical equipment and drugs are also expected to be further supplemented and improved.更多还原