大批量地震伤员的早期救治  

Early remedy for bulk trauma patients in China Wenchuan earthquake

作　　者：黄显凯[1] 沈岳[1] 郭庆山[1] 朱锡光[1] 王芳[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所全军战创伤中心,重庆400042

出　　处：《中华创伤杂志》2008年第12期1037-1039,共3页Chinese Journal of Trauma

摘　　要：目的探讨大批量地震伤员的早期救治方法。方法对1123例地震伤员实施早期救治。受伤部位：四肢伤925例，脊柱伤65例，头部伤46例，胸部伤53例，腹部伤72例。单部位伤809例，多发伤314例。紧急手术67例，其中肝破裂修补13例，脾破裂行脾切除14例，肠系膜血管损伤修补3例，腹部多脏器损伤修补6例，胸腹联合伤行胸腹脏器损伤修补及膈肌破裂修补4例，颅内血肿清除术12例，肺破裂修补4例，肺及支气管部分切除5例，心脏压塞行心包切开1例，连枷胸行肋骨内固定5例。早期手术166例，其中早期单纯清创105例，清创加骨折外固定支架固定36例，截肢25例。结果406例治愈出院，673例经初期治疗后转院治疗，死亡3例。结论分级救治方法适用于大批量地震伤员的早期救治。危重伤员及伴有严重心肺等基础疾病的地震伤员早期应采用损害控制技术。反复检诊是防止延误诊治的有效方法。Objective To explore methods of early treatment of bulk trauma patients caused by Wenchuan earthquake. Methods Early treatment was done on 1123 patients including extremity injuries in 925, spinal injuries in 65, brain injuries in 46, thoracic injuries in 53 and abdominal injuries in 72. There were 809 patients with single part injury and 314 with multiple injury. Emergent operation was performed in 67 patients including 13 with liver repair, 14 with spleenectomy, three with mesentery blood vessel repair, six with repair of multiple abdominal organ injuries, four with repair of ruptured diaphragm and injured organs, 12 with evacuation of intracranial hematoma, four with lung repair, five with partial resection of lung and bronchus, one with pericardium discission and five with internal fixation of ribs. Early operation was carried out in 166 patients including 105 with only debridement, 36 with debridement plus external fixation and 25 with amputation. Results Of all, 406 patients were cured, 673 were transferred to higher level hospitals after fundamental treatment and three died. Conclusion Staged treatment is suitable for early management for bulk trauma patients. Damage control technique should be applied early for critically severe patients and those with severe disease of heart and lung. Repeated examination is efficient to avoid delayed diagnosis and treatment.

关 键 词：自然灾害 创伤和损伤 早期救治 

分 类 号：R641[医药卫生—外科学]