地震伤致严重挤压综合征的救治体会
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摘要
目的:探讨地震伤挤压综合征的诊断及治疗,为地震伤挤压综合征的救治提供参考。方法:对地震伤致严重挤压综合征35例治疗进行总结回顾,观察全身营养支持、积极局部创面处理辅助血液透析,对挤压综合征患者恢复的作用。结果:经过正确的早期处理,逐步清除局部坏死组织,恢复患者心、肾功能,为后续修复创面打下良好基础。结论:尽早解除压迫,正确处理伤肢,及时对坏死组织清除,减少毒素吸收,辅助人工血液透析治疗,有利于提高挤压综合征患者救治成功率。
Objective:To discuss the diagnosis and treatment of the crush syndrome in the earthquake.Methods:Thirty five patients with crush syndrome caused by earthquake were involved the retrospective study.The role of nutritional support,active wound treatment and hemodialysis on the patients' recovery was observed.Results:The function of the heart and kidneys were gradually improved by the planned removal of the necrotic tissue,which laid a foundation for the further repair of the wound.Conclusion:The removal of necrotic tissue,which can decrease the toxic absorption,will improve the success rate for treatment of the crush syndrome patients when being assisted with the hemodialysis.
Objective:To discuss the diagnosis and treatment of the crush syndrome in the earthquake.Methods:Thirty five patients with crush syndrome caused by earthquake were involved the retrospective study.The role of nutritional support,active wound treatment and hemodialysis on the patients' recovery was observed.Results:The function of the heart and kidneys were gradually improved by the planned removal of the necrotic tissue,which laid a foundation for the further repair of the wound.Conclusion:The removal of necrotic tissue,which can decrease the toxic absorption,will improve the success rate for treatment of the crush syndrome patients when being assisted with the hemodialysis.
引文
[1]Gonzales D.Crush Syndrome.Crit Care Med,2005,33(1Suppl):3341.
[2]Adachi J,Morita S,Yasuda H,et al.Elevated plasma nitrate in pa-tients with crush syndrome caused by the Kobe earthquake.Clin Chim Acta,1998,269:137145.
[3]Vanholder R,van der Tol A,De Smet M,et al.Earthquakes and c rush syndrome casualties:lessons learned from the Kashmir disas-ter.Kidney Int,2007,71(1):1723.
[4]Naghii MR.Public health impact and medical consequences of ear thquakes.Rev Panam Salud Publica,2005,18(3):216221.
[5]Raynovich W,Crushed.How proper treatment of crush syndrome sa ved police Sgt.John McLoughlin after22hours under WTC rubble.JEMS,2006,31(9):5865.
[6]Kandil E,Burack J,Sawas A,et al.B type natriuretic peptide:a bi omarker for the diagnosis and risk stratification of patients with septic shock.Arch Surg,2008,143(3):242246.
[7]Vanholder R,Van Biesen W,Hoste E,et al.The role of the renal di saster relief task force in the prevention and treatment of crush syn-drome in mass disasters.Acta Clin Belg Suppl,2007,(2):405407.
[8]Desai Shanti N,Desai PV.The study of Na+,K(+)-ATPase activity of rat brain during crush syndrome.Neurochem Res,2007,32(11):18431848.
[9]Smith TM,Sawyer SF,Sizer PS,et al.The double crush syndrome:a common occurrence in cyclists with ulnar nerve neuropathy a case control study.Clin J Sport Med,2008,18(1):5561.
[10]Kwon HK,Hwang M,Yoon DW.Notice of plagiarism.Frequency and severity of carpal tunnel syndrome according to level of cervical radiculopathy:double crush syndrome.Clin Neurophysiol,2007,118(9):2123.
[11]Aoki N,Demsar J,Zupan B,et al.Predictive model for estimating risk of crush syndrome:a data mining approach.J Trauma,2007,62(4):940945.
[12]Liao YY,Lee TS,Lin YM.Comment on the article'predictive mo del for estimating risk of crush syndrome:a data mining approach'.J Trauma,2007,63(2):451452.
[2]Adachi J,Morita S,Yasuda H,et al.Elevated plasma nitrate in pa-tients with crush syndrome caused by the Kobe earthquake.Clin Chim Acta,1998,269:137145.
[3]Vanholder R,van der Tol A,De Smet M,et al.Earthquakes and c rush syndrome casualties:lessons learned from the Kashmir disas-ter.Kidney Int,2007,71(1):1723.
[4]Naghii MR.Public health impact and medical consequences of ear thquakes.Rev Panam Salud Publica,2005,18(3):216221.
[5]Raynovich W,Crushed.How proper treatment of crush syndrome sa ved police Sgt.John McLoughlin after22hours under WTC rubble.JEMS,2006,31(9):5865.
[6]Kandil E,Burack J,Sawas A,et al.B type natriuretic peptide:a bi omarker for the diagnosis and risk stratification of patients with septic shock.Arch Surg,2008,143(3):242246.
[7]Vanholder R,Van Biesen W,Hoste E,et al.The role of the renal di saster relief task force in the prevention and treatment of crush syn-drome in mass disasters.Acta Clin Belg Suppl,2007,(2):405407.
[8]Desai Shanti N,Desai PV.The study of Na+,K(+)-ATPase activity of rat brain during crush syndrome.Neurochem Res,2007,32(11):18431848.
[9]Smith TM,Sawyer SF,Sizer PS,et al.The double crush syndrome:a common occurrence in cyclists with ulnar nerve neuropathy a case control study.Clin J Sport Med,2008,18(1):5561.
[10]Kwon HK,Hwang M,Yoon DW.Notice of plagiarism.Frequency and severity of carpal tunnel syndrome according to level of cervical radiculopathy:double crush syndrome.Clin Neurophysiol,2007,118(9):2123.
[11]Aoki N,Demsar J,Zupan B,et al.Predictive model for estimating risk of crush syndrome:a data mining approach.J Trauma,2007,62(4):940945.
[12]Liao YY,Lee TS,Lin YM.Comment on the article'predictive mo del for estimating risk of crush syndrome:a data mining approach'.J Trauma,2007,63(2):451452.
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