地震后危重多发伤患者野外条件下的救治体会
详细信息 本馆镜像全文    |  推荐本文 | | 获取馆网全文
摘要
目的:探讨突发灾难后危重多发伤患者在野外条件下的救治方案。方法和结果:患者女性,53岁,因"地震中骨盆砸伤、大量血尿"入院,呼吸困难,全腹压痛,褥疮。便携式B超示腹腔积液,左胸腔积液,膀胱破裂。便携式血气分析仪提示"严重贫血+低氧血症+低钾+酸中毒"。术前行左胸腔穿刺,膀胱穿刺引流。剖腹探查见直肠破裂(穿孔),遂行Harttman手术加膀胱造瘘术和抗感染治疗。术后第18日基本恢复。结论:术者具有精湛的技术和丰富的经验、充分发挥便携式设备的作用、依靠具有地理优势的当地医院、积极抗感染是艰苦环境下救治危重多发伤患者的成功因素。
Objective:To study the rescue strategy for patients with severe multiple injuries after sudden disaster under field condition.Methods and results:A 53-year-old female patient was referred to us after hit on the pelvis in the China Wenchuan earthquake.Her symptoms included large volume of hematuria,difficult breath,tenderness of the whole abdomen,and bedsore. Portable B ultrasound revealed effusion of abdomen and left chest cavity,and bladder rupture.Portable blood-gas analyzer indicated severe anemia+hypoxemia+hypokalemia+acidosis.Drainage was done through left chest cavity aspiration and bladder aspiration. Abdominal examination found rectal rupture(perforation),which was managed by Harttman+cystostomy followed by anti-infection treatment.The patient recovered 18 days after operation.Conclusion:The rich experience and skillful surgical management,the full play of portable equipment,the help from the local hospital,together with timely anti-infection management,are the keys to successful rescue of patients with severe multiple injuries under field condition.
引文
[1]余国强.叶勇雄,曾明金,芳华.野战便携式急救单元构想与实现[J].医疗卫生装备,2007,28:77-78.
    [2]王运斗,裴国献.外军战创伤救治标准化趋势及我军发展对策研究[J].人民军医.2005.48:240-242.
    [3]张康莉.辛阔林,肖鹏云.郑刚.远程会诊技术在野战外科管理的应用[J].解放军医院管理杂志.2007,14:696-697.
    [4]高劲谋.腹部创伤救治进展[J].创伤外科杂志.2007.9:287-288

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