腹部外加压治疗腹部闭合伤腹腔出血在院外急救中的应用  

First aid application of abdominal external pressure on abdominal bleeding ,in blunt abdominal injury

作　　者：郭兴[1] 张磊[1] 王景彬[1] 

机构地区：[1]保定市急救中心,河北071000

出　　处：《中国急救复苏与灾害医学杂志》2013年第6期518-519,共2页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨在院外急救过程中采用腹部外加压治疗腹部闭合伤腹腔出血的应用价值。方法在院外急救中将210例闭合性腹部损伤腹腔出血患者随机分成实验组和对照组，每组105例，对照组采用常规治疗，实验组在常规治疗的基础上，用充气式腹带以60—70mmHg（1mmHg=0．133kpa）的压力外加压，观察、对比两组患者的治疗效果。结果实验组与对照组相比：死亡率明显降低（10．47％：18．10％）；腹腔平均出血量减少[（1343±376）ml：（1709±403）m1]；到达院内时的休克发生率降低（60．78％：77．23％）；两组的腹腔间隔室综合征（ACS）发生率无明显差异（5．71％：3．81％）。结论在院外急救中采用适度的腹部外加压可以减少腹部闭合伤腹腔出血患者的出血量，降低休克发生率和死亡率，且不增加ACS的发生率。Objective Explore the first aid application of abdominal external pressure to abdominal bleeding in blunt abdominal injury. Methods 210 patients of abdominal bleeding in blunt abdominal injury were randomly divided into treatment group and control group with 105 in each group. On top of the normal treatment, an external pressure with aero cyst compression belly-band with 60-70mmHg （lmmHg = 0.133kpa） was adopted for the treatment group to compare the effect between the two groups. Results Mortality of the treatment group was 10.47% comparing with the control group of 18.10%; the average blood loss of abdominal of the treatment group was （1 343±376） ml comparing with the control group of （1 709±403） ml; the rate of shock of the treatment group was 60.78% comparing with the control group of 77.23% at the time they were sent in the hospital. It reflected no significant difference in abdominal compartment syndrome （ACS） between the two groups （5.71%±3.81%）. Conclusion Moderate abdominal external pressure in pre-hospital stage is considered being effective in reducing amount of abdominal bleeding, incidence of shock and the mortality without increasing the chances for abdominal compartment syndrome （ACS）.

关 键 词：腹部外加压 腹部闭合伤腹腔出血 院外急救 腹腔内高压 

分 类 号：R459.7[医药卫生—急诊医学]