53例地震伤员后方医院救治期间的病情观察
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摘要
总结了53例地震伤员后方医院救治过程中的病情观察要点。地震灾区患者病情复杂、合并症多,后方医院接诊患者时全面评估病情,及时发现并发的伤情。诊断为胸腰椎骨折和骨盆骨折的患者密切观察有无合并颈、腰椎骨折的现象。密切观察截肢患者残端皮肤黏膜的血液充盈、皮温、颜色及肿胀情况;对高位截肢患者注意用药剂量与患者的反应;骨折患者观察骨折固定器的使用情况,防止固定器过紧出现肢体坏死;挤压综合征患者密切观察全身情况及肢体血运和肿胀情况,防止肾功能衰竭、肺栓塞和肢体坏死等并发症。密切观察患者有无出现应激性高血糖、高血压、胃溃疡等疾病。同时注意家属中有无存在疾病的相关症状、体征,以早期发现疾病、早期治疗。
This paper sums up the key points of condition observation in the rescue and treatment of 53 earthquake casualties by the rear hospital.As the injuries of these casualties are large in number with various complications,the rear hospital should conduct an overall assessment of the injury situation when treating the casualties and spot the complications in time.For those diagnosed with thoracolumbar or pelvic fractures,close attention should be paid to whether there are cervical spine or lumbar vertebra fractures associated.For the injured who underwent amputation,close observation should be made of the blood filling,temperature,color and swelling of the skin and mucocutaneous,and for those with high level amputation,attention should be paid to the dosage and the reaction of the casualty.For those with bone fractures,observation should be made of the usage of the fracture fixator to prevent the overtightening of the fixator,which can lead to limb necrosis.For those with extrusion syndromes,close observation should be made of the ovall physical condition,the blood supply and swelling in order to prevent such complications as renal function failure,pulmonary embolism and limb necrosis,etc.And for all,close observation should be made about whether there occurs stress hyperglycemia,hypertension or gastric ulcer,etc.And attention should be paid to whether the dependents showed symptoms and signs of related diseases to faciliate the early diagnosis and treatment.
This paper sums up the key points of condition observation in the rescue and treatment of 53 earthquake casualties by the rear hospital.As the injuries of these casualties are large in number with various complications,the rear hospital should conduct an overall assessment of the injury situation when treating the casualties and spot the complications in time.For those diagnosed with thoracolumbar or pelvic fractures,close attention should be paid to whether there are cervical spine or lumbar vertebra fractures associated.For the injured who underwent amputation,close observation should be made of the blood filling,temperature,color and swelling of the skin and mucocutaneous,and for those with high level amputation,attention should be paid to the dosage and the reaction of the casualty.For those with bone fractures,observation should be made of the usage of the fracture fixator to prevent the overtightening of the fixator,which can lead to limb necrosis.For those with extrusion syndromes,close observation should be made of the ovall physical condition,the blood supply and swelling in order to prevent such complications as renal function failure,pulmonary embolism and limb necrosis,etc.And for all,close observation should be made about whether there occurs stress hyperglycemia,hypertension or gastric ulcer,etc.And attention should be paid to whether the dependents showed symptoms and signs of related diseases to faciliate the early diagnosis and treatment.
引文
[1]新华网.一次史无前例的生命接力-四川地震伤员大转移纪实[EB/OL].(2008-7-12).[2008-7-28].http://news.xinhuanet.com/newscenter/2008-05/25/content_8249558.htm.
[2]张永青,杨造成,彭碧波,等.巴拉考特地震灾区发病状况分析[J].武警医学,2006,17(2):154-155.
[3]樊毫军,马洪杰,谢景红,等.巴基斯坦地震灾害搜救现场的救护体会[J].护理学报,2006,13(2):51-52.
[4]孙宏勋,谢永富.骨折患者应激性血清转氨酶异常增高的临床意义[J].河北医药,2008,30(3):343.
[5]施巧宜.动力髋螺钉内固定术治疗股骨粗隆间骨折患者的护理[J].护理学报,2005,12(11):43-45.
[2]张永青,杨造成,彭碧波,等.巴拉考特地震灾区发病状况分析[J].武警医学,2006,17(2):154-155.
[3]樊毫军,马洪杰,谢景红,等.巴基斯坦地震灾害搜救现场的救护体会[J].护理学报,2006,13(2):51-52.
[4]孙宏勋,谢永富.骨折患者应激性血清转氨酶异常增高的临床意义[J].河北医药,2008,30(3):343.
[5]施巧宜.动力髋螺钉内固定术治疗股骨粗隆间骨折患者的护理[J].护理学报,2005,12(11):43-45.
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