多功能胸腰固定救生马甲的研制与应用  

Development and application of a multifunctional thoracolumbar fixation rescue vest

作　　者：严力生[1] 鲍宏玮[1] 钱海平[1] 罗旭耀[1] 

机构地区：[1]解放军第四一一医院骨科,上海200081

出　　处：《中华创伤杂志》2015年第2期148-152,共5页Chinese Journal of Trauma

摘　　要：目的 研制一种集平时陆地和水上救生为一体的胸腰椎外固定救生马甲,并探讨其应用效果. 方法 采用热塑型聚氨酯（TPU）-尼龙复合物及聚碳酸酯（PC）为主要材料,根据胸腰部生理弧度,研制出以龙骨为支撑、气囊充气加压而起到制动与固定作用的Ⅰ型胸腰固定救生马甲;在此基础上增加了救生气囊及自涨式压缩充气钢瓶的Ⅱ型.分析Ⅰ型胸腰固定救生马甲在胸腰椎损伤532例的临床应用,并观察Ⅱ型胸腰固定救生马甲应用于海上救生时自动充气时间、浮力、水上漂浮时间、漂浮状态及伤员面部朝向等指标.临床疗效采用MacNab评定标准,腰痛使用视觉模拟评分（VAS）. 结果 根据MacNab评定标准,所有患者均为优,VAS从使用前的8.2分降至使用后2分,改善率为100％.落水后自动充气时间3～5s.救生固定马甲的浮力能达到100 kg,90 kg假人海上漂浮时间＞96 h,伤员漂浮时能确保面部朝上状态,24 h浮力损失≤5％,穿戴后水上漂浮状态下的四肢可自由活动. 结论 多功能胸腰固定救生马甲能形成双重固定,在落水后自动充气而确保救生功能,对胸腰椎骨折患者在船舱内的搬动、转运及后送提供可行性.Objective To develop an all-in-one multifunctional thoracolumbar fixation rescue vest for land and water rescue of thoracolumbar injury and investigate its application effect.Methods According to the thoracolumbar physiological curve,type Ⅰ thoracolumbar fixation rescue vest with keel and inflatable airbag and type Ⅱ thoracolumbar fixation rescue vest with additional lifesaving balloon and inflatable cylinder were developed using thermoplastic polyurethane （TPU）-nylon composites and polycarbonate （PC） as the main materials.Clinical application of type Ⅰ thoracolumbar fixation rescue vest in 532 cases of thoracolumbar injury was discussed.Type Ⅱ thoracolumbar fixation rescue vest were tested at marine rescue and related parameters measured were automatic inflation time,buoyancy force,floating time,floating condition and victims＇ face orientation.Clinical outcome was quantified by the MacNab standard,and VAS for pain was recorded.Results According to the MacNab standard,excellent outcome was achieved for all cases.VAS improved from 8.2 points to 2 points after the bracing was applied,showing 100% improvements.The brace into the water showed automatic inflation time of 3-5 seconds and maximum buoyancy force of 100 kg,and ensured a 90 kg dummy of floating over 96 hours.At marine rescue,the wounded in braced condition showed face upward with 24-hour buoyancy loss ≤5% and freedom of movement.Conclusions The multifunctional thoracolumbar fixation rescue vest provides dual immobilization and ensures marine rescue for its automatic inflation device.This invention provides the feasibility to remove,transport and evacuate the thoracolumbar fracture patients in cabin.

关 键 词：脊柱损伤 胸椎 腰椎 急救医疗服务 

分 类 号：R197.39[医药卫生—卫生事业管理]