对地震挤压伤患者院前急救的反思与研讨
摘要
目的:为挤压伤者的院前急救进行反思和研讨,提出一些新建议,以提高这类伤员的抢救成功率。材料和方法:本文特利用循证医学技术和方法,通过病例分析和文献回顾总结的方式。结果:通过文献回顾和病例分析,地震中挤压伤的院前处理应该注意以下几点:首先是重视早期补液的重要性,特别是液体的类型、量和补碱利尿时机;其次是局部患肢结扎,肢体处理和情绪的稳定;最后伤者获救后切忌盲目转运,现场分拣和急救后再转运。结论:应重视地震伤员院前急救过程中的规范化处理,以期最终改善预后,减少急性肾功衰和脓毒血症的发生,降低病残率和死亡率。
引文
[1]VANHOLDER R,SEVER M S,EREK E,et al.Acute renal fail-ure related to crush syndrome:towards an era of seismo-nephrology[J]?Nephrol Dial Transplant,2000,15:1517-1521.
[2]SEVER M S,VANHOLDER R,LAMEIRE N.Management ofcrush-related injuries after disasters[J].N Engl J Med,2006,354,1052-1063.
[3]BETTER O S.The crush syndrome revisited(1940-1990)[J].Nephron,1990,55:97-103.
[4]RAMIN T,DOROTHEA W,MOHAMMAD HL,et al.Oral al-kalinizing solution as a potential prophylaxis againstmyoglobinuricacute renal failure:preli minary data from healthy volunteers[J].Nephrol Dial Transplant,2005,20:1228-1231.
[5]VANHOLDER R,SEVER M S,EREK E,et al.Rhabdomyolysis[J].J Am Soc Nephrol,2000,11(8):1553-1561.
[6]BETTER O S.Rescue and salvage of casualties suffering from thecrush syndrome after mass disasters[J].Mil Med,1999,164:366-369.
[7]盛志勇.努力提高脓毒症的认识水平[J].中国危重病急救医学,2003,15(3):1311.
[8]马胜银,刘朝阳.连续性肾脏替代疗法在治疗伴急性肾功能衰竭的多器官功能障碍综合征中的应用[J].中国危重病急救医学,2003,15(2):97991.
[2]SEVER M S,VANHOLDER R,LAMEIRE N.Management ofcrush-related injuries after disasters[J].N Engl J Med,2006,354,1052-1063.
[3]BETTER O S.The crush syndrome revisited(1940-1990)[J].Nephron,1990,55:97-103.
[4]RAMIN T,DOROTHEA W,MOHAMMAD HL,et al.Oral al-kalinizing solution as a potential prophylaxis againstmyoglobinuricacute renal failure:preli minary data from healthy volunteers[J].Nephrol Dial Transplant,2005,20:1228-1231.
[5]VANHOLDER R,SEVER M S,EREK E,et al.Rhabdomyolysis[J].J Am Soc Nephrol,2000,11(8):1553-1561.
[6]BETTER O S.Rescue and salvage of casualties suffering from thecrush syndrome after mass disasters[J].Mil Med,1999,164:366-369.
[7]盛志勇.努力提高脓毒症的认识水平[J].中国危重病急救医学,2003,15(3):1311.
[8]马胜银,刘朝阳.连续性肾脏替代疗法在治疗伴急性肾功能衰竭的多器官功能障碍综合征中的应用[J].中国危重病急救医学,2003,15(2):97991.
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