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目的 调查嘉定区院外昏迷患者的基本资料及低年资医生(从业年限在3年以下)和高年资医生(从业年限在3年以上)对昏迷患者的评估与处理.方法 回顾性收集2015年1月1日-12月31日嘉定区医疗急救中心昏迷患者临床资料(年龄≥3岁),包括性别、年龄、疾病分类、急救反应时间及院外病死率.对低年资医生与高年资医生对院外接诊昏迷患者的格拉斯哥昏迷评分(GCS)、创伤指数(TI)、检查率和病死率进行统计分析.结果 ①共收集昏迷患者1402例,男885例,女517例,平均年龄(61.72±22.05)岁,男性年龄均数小于女性[(58.03±21.47)岁vs(68.05±21.60)岁,(P＜0.05)].昏迷疾病构成比排名前四位分别是急性卒中(21.04％),严重创伤(14.69％),OHCA(13.48％),中毒(10.91％).GCS平均评分(6.30±3.66)分,TI评分(12.68±5.20),急救反应时间(10.23±5.62)分钟,昏迷患者院外死亡458例(32.67％);②两组医生现场接诊昏迷患者性别构成比、平均年龄、前四位疾病分类构成比和急救反应时间均无明显统计学差异(P＞0.05);③高年资医生组的昏迷患者GCS平均评分低于低年资医生组的GCS平均评分[(6.0±3.55) vs (6.94±3.83),(P=0.00)],且GCS评分为3分的昏迷患者占比也多(46.44％ vs 37.50％,P＜0.05),而高年资医生组接诊创伤昏迷患者TI评分高于低年资医生组[(13.49±5.12) vs (10.72±4.91),(P=0.00)];高年资医生组对昏迷患者的检查率(血糖监测、12-EKG)和处理率均高于低年资医生组(P＜0.05),但院外病死率并无统计学差异(33.33％vs 31.25％,P＞ 0.05).结论 昏迷患者院外病死率高,应该加强急救医生尤其是低年资医生对昏迷患者的现场评估与综合救治能力.“,”Objective The aim of this study was to determine whether the professional time can affect the quality of assessing and treating coma patients in prehospital rescue.Methods We performed a retrospective review of prehospital coma patients,older than 3 yrs,from Jiading emergency medical services systems of Shanghai in 2015 We randomly divided the patients into junior-group and senior-group.Age,gender,cause of coma,interval between call and first EMS response and death rate out of hospital were recorded.The Glasgow Coma Scale(GCS),Trauma Index (TI),inspect rate and death rate were retrospectively analyzed.Results ①A total of 1402 cases with coma were enrolled.885 were males and the rest 517 were females Mean age was 61.72±22.05 yrs,females were older than males (58.03± 21.47yrs vs.68.05± 21.60yrs,P＜0.05).②The top four diseases induced coma were cerebral vascular (21.04％),trauma(14.69％),OHCA (out-of-hospital cardiac arrest)(13.48％),poisonous disease (10.91％).Mean GCS was 6.30±3.66,Mean TI was 12.68±5.20,Mean interval between call and first EMS response was 10.23±5.62 min,458 cases died out of hospital (32.67％);②There were no significant differences between the two group neither in gender,age,the top four kinds of diseases and in mean interval between call and first EMS response (P＞0.05).③senior-group patients were more likely to present with low GCS and high TI,check the patients more carefully and treat the patients more reasonably compared to the junior-group (P＜0.05).However,mortality rate were statistically the same in two group(P＞ 0.05).Conclusions Patients with coma have high mortality rate on site,the doctors especially the junior need to develop training skills.