地震灾害中的创伤类型、死亡原因和急救处理
摘要
本文简要综述了地震中的常见创伤类型、死亡原因和急救处理的有关问题。地震创伤以四肢损伤最多见、骨折占第一位,颅脑伤、胸部挤压伤和多发性肋骨骨折与血气胸、软组织伤、腹部闭合伤也比较常见;地震造成的建筑物垮塌、靠近建筑物外墙、泥石流埋压是即刻死亡的直接原因;获救伤员中颅脑损伤的死亡率最高,其次是窒息、创伤性休克和躯体受压的人员;而在延迟死亡的患者中以挤压伤综合征、严重感染、多器官功能障碍多见;而急救应强调止血、窒息、创伤性休克的复苏和挤压伤的处理,特别要重视较长时间埋压伤员的病理生理变化及其在治疗中的特殊性。
引文
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[13]Abdo T,A Dorzi H,Itani AR,et al.Earthquakes:health outcomes and implications in Lebanon[J].J Med Liban,1997,45(4):197-200.
[14]Shimazu T,Yoshioka T,Nakata Y,et al.Fluid resuscita-tion and systemic complications in crush syndrome:14Hanshin-Awaji earthquake patients[J].J Trauma,1997,42(4):641-646.
[15]Adachi K,Kawata M,Araki S,et al.Acase of Crush syn-drome with giant negative T waves and reversible left ventricular dysfunction[J].Jpn Circ J,1996,60(10):809-814.
[2]Sheng ZY.Medical support in the Tangshan earthquake:a review of the management of mass casualties and certain major injuries[J].J Trauma,1987,27(10):1130-1135.
[3]北京军区后勤部、卫生部.抗震救灾卫勤保障经验选编[M].北京:北京军区后勤部,1976.
[4]Bozkurt M,Ocguder A,Turktas U,et al.The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in2005[J].Injury,2007,38:290-297.
[5]Maegele M,Gregor S,Steinhausen E,et al.The long-dis-tance tertiary air transfer and care of tsunami victims:in-jury pattern and microbiological and psychological aspects[J].Crit Care Med,2005,33(5):1136-1140.
[6]Emami MJ,Tavakoli AR,Alemzadeh H,et al.Strategies in evaluation and management of Bamearthquake victims[J].Prehosp Disaster Med,2005,20(5):327-330.
[7]Roy N,Shah H,Patel V,et al.Surgical and psychosocial outcomes in the rural injured——a follow-up study of the2001earthquake victims[J].Injury,2005,36(8):927-934.
[8]Papadopoulos IN,Kanakaris N,Triantafillidis A,et al.Autopsy findings from111deaths in the1999Athens earthquake as a basis for auditing the emergency response[J].Br J Surg,2004,91(12):1633-1640.
[9]Pretto EA,Angus DC,Abrams JI,et al.An analysis of prehospital mortality in an earthquake.Disaster Reani-matology Study Group[J].Prehosp Disaster Med,1994,9(2):107-117.
[10]Alexander D.The health effects of earthquakes in the mid-1990s[J].Disasters,1996,20(3):231-247.
[11]Tanaka H,Oda J,Iwai A,et al.Morbidity and mortality of hospitalized patients after the1995Hanshin-Awaji earthquake[J].AmJ Emerg Med,1999,17(2):186-191.
[12]Ellidokuz H,Ucku R,Aydin UY,et al.Risk factors for death and injuries in earthquake:cross-sectional study from Afyon,Turkey[J].Croat Med J,2005,46(4):613-618.
[13]Abdo T,A Dorzi H,Itani AR,et al.Earthquakes:health outcomes and implications in Lebanon[J].J Med Liban,1997,45(4):197-200.
[14]Shimazu T,Yoshioka T,Nakata Y,et al.Fluid resuscita-tion and systemic complications in crush syndrome:14Hanshin-Awaji earthquake patients[J].J Trauma,1997,42(4):641-646.
[15]Adachi K,Kawata M,Araki S,et al.Acase of Crush syn-drome with giant negative T waves and reversible left ventricular dysfunction[J].Jpn Circ J,1996,60(10):809-814.
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