目的 观察脊柱损伤合并多发伤患者的急诊预见性护理的效果, 探讨脊柱损伤合并多发伤合理急诊护理的措施。方法 本院急诊科接诊的86例脊柱损伤合并多发伤患者, 按掷币法随机分为观察组(n=44)和对照组(n=42), 观察组采用预见性护理, 对照组应用常规护理。记录救护车到达时间(发病至救护车到达时间)、有效抢救时间(从救护车到达至患者入院治疗的时间)、急救成功率(判断标准为经抢救后, 患者生命体征缓解, 转入住院或手术等治疗)及患者负面情绪发生率(恐惧、焦虑、烦躁为主), 并对结果进行统计学分析。结果 两组救护车到达时间无统计学差异;观察组有效抢救时间(27.7±4.4) min, 急救成功率95.5%, 负面情绪发生率13.6%;对照组有效抢救时间(34.6±4.1)min, 急救成功率80.9%, 负面情绪发生率28.6%;两组比较差异均具有统计学意义(P＜0.05)。结论 多发伤中脊柱脊髓损伤基本处理原则是抢救患者生命, 因多发伤患者中脊柱脊髓损伤早期诊断困难、易漏诊, 治疗上应严格限制颈部活动及防止脊髓进一步损伤, 更是尤为重要。

Objective To study the effect of emergency foresight nursing care and reasonable nursing measures on patients with spinal cord injury combined with multiple injuries. Methods Eighty-six patients with spinal cord injury and multiple trauma were enrolled in emergency department of this hospital from October 2010 to October 2013. According to the toss of a coin they were randomly divided into the observation group (n=44) and the control group (n=42). The observation group received foreseeable nursing whereas the control group shared routine nursing care. The ambulance arrival time (the time from onset of disease to the ambulance arrival), the effective rescue time (the time from the ambulance rrival to patients’ hospitalization), the successful rate of first aid (as a criterion, after the rescue, the vital signs of the patients were relieved and transfer to hospitalization or surgical treatment), and incidence and patients’ negative emotions (fear, anxiety, irritability) were recorded, and the Results were statistically analyzed. Results There was no significant difference in ambulance arrival time. In observation group, the average effective rescue time was (27.7±4.4) min, the success rate of first aid was 95.5%, incidence of negative emotions was 13.6%. In the control group, the average effective rescue time was (34.6±4.1)min, the success rate of first aid was 80.9%, and negative emotions incidence was 28.6%. The difference was significant (P＜0.05) between the two groups. Conclusions For multiple injuries with spinal cord injury, the basic principle is to save the lives of patients. Owing to difficulties in early diagnosis and easily missed diagnosis of spinal cord injury in multiple trauma patients with spinal cord injury, neck mobility should be strictly limited and further spinal damage should be prevented, which is particularly important to the treatment.