地震群体多发伤的救治分析
|
摘要
目的总结汶川地震中群体多发伤患者的救治经验。方法回顾性分析2008年5月12日~31日我院收治的454例地震多发伤患者临床资料。结果所有伤员中,气管插管或气管切开57例,胸腔闭式引流71例,急诊手术213例,死亡37例,死亡率8.1%。其中失血性或(和)创伤性休克29例,特重型颅脑伤12例、多器官功能衰竭2例。结论地震群体多发伤的特点是:伤员多而集中,伤情重而复杂,需要全体动员,统一组织,诊治小组迅速初诊、分流,重点抢救,注意多发伤的抢救处理重点和先后顺序,积极防治并发症,防止漏诊和误诊,才能最大程度的挽救生命,降低死亡率和致残率。
Objective To summarize the treatment experiences of the group multiple trauma patients injured in Wenchuan earthquake.Methods The 454 cases,hospitalized in our hospital from May 12 to May 31,2008,were retrospectively analyzed.Results In 454 cases,57 cases were performed by tracheal intubation or tracheotomy,71 cases by thoracic close drainage,213 cases by emergency surgery.Among all of those patients,37 cases died,and the mortality was 8.1%,among whom,30 cases died within 8hours and 7cases died after 8hours.And 29 cases died of traumatic or hemorrhagic shock,12 cases extra severe traumatic brain injury,2 cases multiple organ failure.Conclusion The characteristics of the group multiple trauma patients injured in earthquake are that the wounded are mass and concentrated,and the injury condition is serious and complicated.Unified command,treatment of the wounded according to the technical principles at divisional levels,active precaution and treatment of complication,and effective prevention of missed diagnosis and mis-diagnosis,are important measures to reduce the casualty and disability.
Objective To summarize the treatment experiences of the group multiple trauma patients injured in Wenchuan earthquake.Methods The 454 cases,hospitalized in our hospital from May 12 to May 31,2008,were retrospectively analyzed.Results In 454 cases,57 cases were performed by tracheal intubation or tracheotomy,71 cases by thoracic close drainage,213 cases by emergency surgery.Among all of those patients,37 cases died,and the mortality was 8.1%,among whom,30 cases died within 8hours and 7cases died after 8hours.And 29 cases died of traumatic or hemorrhagic shock,12 cases extra severe traumatic brain injury,2 cases multiple organ failure.Conclusion The characteristics of the group multiple trauma patients injured in earthquake are that the wounded are mass and concentrated,and the injury condition is serious and complicated.Unified command,treatment of the wounded according to the technical principles at divisional levels,active precaution and treatment of complication,and effective prevention of missed diagnosis and mis-diagnosis,are important measures to reduce the casualty and disability.
引文
[1]高仕铭,骆松明,陆斌杰.突发事件中群体伤员抢救组织工作的几点体会[J].中华医院管理杂志,2003,19(6):342-343.
[2]赵喜森.重症难治性休克的机制和治疗[J].中华创伤杂志,2003,19(16):325.
[3]Wetzel RC.Multiple trauma in children:critical care over-view[J].Crit Care Med,2002,30(S):468-477.
[4]王一镗.严重创伤救治的策略-损伤控制性手术[J].中华创伤杂志,2005,21(1):32-35.
[5]Hoey BA,Schwab CW.Damage control surgery[J].Scand JSurg,2002,91(1):92-103.
[6]Wanek S,Mayberry JC.Blunt thoracic trauma:flail chest,pulmonary contusion,and blast injury[J].Crit Care Clin,2004,20(1):71-81.
[7]杨帆,白祥军,唐朝晖,等.4519例多发伤院内救治分析[J].中国医学科学院学报,2007,29(4):471-477.
[8]Kenneth LM,David VF,Emest EM.Trauma[M].4th ed.McGraw-Hill,2000.203-205.
[9]Buduhan G,McRitchie DI.Missed injuries in patients withmultiple trauma[J].J Trauma,2000,49(4):600-605.
[10]李力群,蔡汝宾.严重多发伤在加强医疗中的几个问题[J].中国急诊医学杂志,2003,12(8):573-584.
[11]梁贵友,牛义民,刘达兴,等.连枷胸的机械通气治疗[J].中华创伤杂志,2005,21(7):531-534.
[2]赵喜森.重症难治性休克的机制和治疗[J].中华创伤杂志,2003,19(16):325.
[3]Wetzel RC.Multiple trauma in children:critical care over-view[J].Crit Care Med,2002,30(S):468-477.
[4]王一镗.严重创伤救治的策略-损伤控制性手术[J].中华创伤杂志,2005,21(1):32-35.
[5]Hoey BA,Schwab CW.Damage control surgery[J].Scand JSurg,2002,91(1):92-103.
[6]Wanek S,Mayberry JC.Blunt thoracic trauma:flail chest,pulmonary contusion,and blast injury[J].Crit Care Clin,2004,20(1):71-81.
[7]杨帆,白祥军,唐朝晖,等.4519例多发伤院内救治分析[J].中国医学科学院学报,2007,29(4):471-477.
[8]Kenneth LM,David VF,Emest EM.Trauma[M].4th ed.McGraw-Hill,2000.203-205.
[9]Buduhan G,McRitchie DI.Missed injuries in patients withmultiple trauma[J].J Trauma,2000,49(4):600-605.
[10]李力群,蔡汝宾.严重多发伤在加强医疗中的几个问题[J].中国急诊医学杂志,2003,12(8):573-584.
[11]梁贵友,牛义民,刘达兴,等.连枷胸的机械通气治疗[J].中华创伤杂志,2005,21(7):531-534.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心