地震灾害中儿童创伤危重症的救治
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摘要
儿童自我防护能力较差,在自然灾害中,儿童是最易受到伤害的群体。地震中死亡的主要原因包括心搏呼吸骤停、严重颅脑损伤、休克、挤压综合征及多脏器功能衰竭。优先实施对儿童的集中、有效救治,并实现多学科交叉合作,将危重患儿集中在有条件的PICU平台上,可提高重症患儿的存活率、降低致残率。
Children are the most vulnerable in natural disasters for their poor self-protection ability.Pediatric deaths in earthquakes are mainly due to cardiopulmonary arrest,severe craniocerebral injury,shock,crush syndrome,and multiple organ failure.Priority should be given to centralized,effective treatment for injured children,with multidisciplinary cooperation,and severe cases need to be transferred to the pediatric intensive care unit,thus improving survival and reducing disability.
Children are the most vulnerable in natural disasters for their poor self-protection ability.Pediatric deaths in earthquakes are mainly due to cardiopulmonary arrest,severe craniocerebral injury,shock,crush syndrome,and multiple organ failure.Priority should be given to centralized,effective treatment for injured children,with multidisciplinary cooperation,and severe cases need to be transferred to the pediatric intensive care unit,thus improving survival and reducing disability.
引文
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[6]Demirkiran O,Dikmen Y,Utku T,Urkmez S.Crush syndromepatients after the Marmara earthquake[J].Emerg Med J,2003,20(3):247-250.
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[11]Ali IG,Huseyin C,Ayhan D,Hudson-Civetta J,Shatz DV,Mat-aragas NR,et al.Early and vigorous fluid resuscitation preventsacute renal failure in the crush victims of catastrophic earthquakes[J].J Am Soc Nephrol,2004,15(7):1862-1867.
[12]Sever MS,Vanholder R,Lameire N.Management of crush relatedinjuries after disasters[J].N Engl J Med,2006,354(10):1052-1063.
[13]符宜龙,敖晓晓,冉迎春,王昱,许峰.地震伤患儿挤压综合征及其严重程度的相关因素分析[J].中华儿科杂志,2009,5(49):328-331.
[14]Chunguang Z,Rigao C,Fuguo H,Chongqi T,Yueming S,Guan-glin W,et al.Characteristics of crush syndrome caused by pro-longed limb compression longer than 24 h in the Sichuan earth-quake[J].Emerg Med J,2010,27(8):627-630.
[15]Li W,Qian J,Liu X,Zhang Q,Wang L,Chen D,et al.Man-agement of severe crush injury in a front-line tent ICU after 2008Wenchuan earthquake in China:an experience with 32 cases[J].Crit Care,2009,13(6):R178.
[16]王昱,许峰.地震伤后挤压综合征的救治进展[J].中华儿科杂志,2009,47(5):352-354.
[17]李广然,张涤华.挤压伤致急性肾衰竭的治疗[J].新医学,2008,39(11):708-709.
[18]许峰.汶川地震带给儿科医师的思考[J].中华儿科杂志,2009:47(5):325-327.
[2]Bhatti SH,Ahrned I,Qureshi NA,Akram M,Khan J.Head traumadue to earthquake October.2005-experience of 300 cases at theCombined Military Hospital Rawalpindi[J].J Coil Physicians SurgPak,2008,18(1):22-26.
[3]Haojun F,Jianqi S,Shike H.Retrospective,analytical study offield first aid following the Wenchuan Earthquake in China[J].Prehosp Disaster Med,2011,26(2):130-134.
[4]Koster RW,Baubin MA,Bossaert LL,Caballero A,Cassan P,Castrén M.European Resuscitation Council Guidelines for Resus-citation 2010 Section 2.Adult basic life support and use of auto-mated external defibrillators[J].Resuscitation,2010,81(10):1277-1292.
[5]Dellinger RP,Levy MM,Rhodes A,Annane D,Gerlach H,OpalSM,et al.Surviving sepsis campaign:international guidelines formanagement of severe sepsis and septic shock[J].Crit Care Med,2008,36(1):296-327.
[6]Demirkiran O,Dikmen Y,Utku T,Urkmez S.Crush syndromepatients after the Marmara earthquake[J].Emerg Med J,2003,20(3):247-250.
[7]冉迎春,敖晓晓,刘岚,符宜龙,庞慧,许峰.地震伤患儿感染创面病原菌分布与耐药性分析[J].中华儿科杂志,2009,47(5):332-336.
[8]张新,翁玲,李用国.地震后危重多发伤伴混合感染病例分析[J].微生物与感染,2008,9(3):155-196.
[9]邓丽静,康焰,王波,廖雪莲,王存真.地震伤患者急性呼吸窘迫综合征临床资料分析[J].中华内科杂志,2008,47(9):718-720.
[10]Kirton OC,Windsor J,Wedderbum R,Hudson-Civetta J,ShatzDV,Mataragas NR,et al.Failure of splanchnic resuscitation inthe acutely injured trauma patient correlates with multiple organsystem failure and length of stay in the ICU[J].Chest,1998,l13(4):1064-1069.
[11]Ali IG,Huseyin C,Ayhan D,Hudson-Civetta J,Shatz DV,Mat-aragas NR,et al.Early and vigorous fluid resuscitation preventsacute renal failure in the crush victims of catastrophic earthquakes[J].J Am Soc Nephrol,2004,15(7):1862-1867.
[12]Sever MS,Vanholder R,Lameire N.Management of crush relatedinjuries after disasters[J].N Engl J Med,2006,354(10):1052-1063.
[13]符宜龙,敖晓晓,冉迎春,王昱,许峰.地震伤患儿挤压综合征及其严重程度的相关因素分析[J].中华儿科杂志,2009,5(49):328-331.
[14]Chunguang Z,Rigao C,Fuguo H,Chongqi T,Yueming S,Guan-glin W,et al.Characteristics of crush syndrome caused by pro-longed limb compression longer than 24 h in the Sichuan earth-quake[J].Emerg Med J,2010,27(8):627-630.
[15]Li W,Qian J,Liu X,Zhang Q,Wang L,Chen D,et al.Man-agement of severe crush injury in a front-line tent ICU after 2008Wenchuan earthquake in China:an experience with 32 cases[J].Crit Care,2009,13(6):R178.
[16]王昱,许峰.地震伤后挤压综合征的救治进展[J].中华儿科杂志,2009,47(5):352-354.
[17]李广然,张涤华.挤压伤致急性肾衰竭的治疗[J].新医学,2008,39(11):708-709.
[18]许峰.汶川地震带给儿科医师的思考[J].中华儿科杂志,2009:47(5):325-327.
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