中华灾害救援医学

目的 探讨院前急救对颅脑外伤手术患者临床预后的影响。方法 选取2024年3月至2025年3月连云港市第一人民医院神经外科收治的60例颅脑外伤手术患者的临床资料进行回顾性分析，根据急救方式的不同分为观察组（患者入院前经院前急救干预）和对照组（患者自行就医，未经院前急救干预），并对两组基线资料进行1∶1倾向性评分匹配，最终每组纳入30例。比较两组急救效率、临床指标、术后30d不良事件发生率以及术后90d格拉斯哥预后量表（GOS）评分。结果 两组急诊科抢救时间比较差异无统计学意义（P>0.05）；观察组受伤至急诊干预时间、受伤至手术时间均短于对照组（P<0.05）。观察组乳酸恢复时间、体温恢复时间均短于对照组；观察组术后7d的格拉斯哥昏迷评分（GCS）高于对照组（P<0.05）。观察组术后30d不良事件发生率低于对照组（P<0.05）；观察组术后90d整体预后情况优于对照组（P<0.05）。结论 对颅脑外伤手术患者实施院前急救可有效缩短受伤至急诊干预及手术的时间，促进患者乳酸水平和体温更快恢复，提高术后早期GCS评分，降低术后不良事件发生率，并改善患者预后。

Objective To investigate the effect of pre-hospital emergency care on the clinical prognosis of patients with craniotomy for head. Methods The clinical data of 60 patients with craniotomy for head trauma treated in the Department of Neurosurgery of the First People's Hospital of Lianungang from March 2024 to March 2025 were retrospectively analyzed. According to the different pre-hospital emergency care, the patients were divided observation group(patients received pre-hospital emergency care before admission) and control group(patients sought medical care by themselves without pre-hospital emergency care). And baseline data of the two groups were 1:1 propensity score matched, finally, 30 cases of patients' data were included in each group. The efficiency of prehospital emergency care, clinical indicators, the incidence of adverse events within 30 days after operation and the Glasgow outcome scale(GOS) score at 90 days after were compared between the two groups. Results There was no statistically significant difference in the time of resuscitation in the emergency department between the two groups(P > 0.05); the time from injury to emergency intervention and from injury to surgery in the observation group was shorter than that in the control group(P < 0.05). The of lactate and body temperature recovery in the observation group was shorter than that in the control group, and the Glasgow coma scale(GCS) score of the observation group atoperative 7 d was higher than that in the control group(P < 0.05). The incidence of adverse events within 30 days after surgery in the group was lower than that in the control group(P < 0.05); the overall prognosis of the observation group within 90 days after surgery was better than in the control group(P < 0.05). Conclusion Prehospital resuscitation for patients with craniotomy due to brain injury can effectively shorten the from injury to emergency intervention and surgery, promote faster recovery of lactate and body temperature, improve early postoperative GCS scores, reduce the incidence of postoperative adverse events, and patient prognosis.