严重创伤漏诊引发医疗纠纷二例反思  

Reflection of Medical Disputes Caused by 2 Cases of Severe Trauma

作　　者：张连阳[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军战创伤中心,创伤,烧伤与复合伤国家重点实验室,重庆400042

出　　处：《临床误诊误治》2015年第4期77-79,共3页Clinical Misdiagnosis & Mistherapy

基　　金：国家"十二五"科技支撑计划(2012BAI11B01);国家科技惠民计划(2013GS500101);重庆市集成示范计划(cstc2013jcsf C10001)

摘　　要：严重创伤救治时效性的提高需建立在救治人员掌握正确的伤情评估策略和技术的基础上,本文回顾分析2例严重创伤漏诊引发医疗纠纷病例资料,阐述在院内紧急救治阶段可能发生的误漏诊情况,包括未根据血流动力学状态决定患者的救治策略,未有效评估胸部创伤,影像学检查流程和策略不当,缺乏复苏效果的动态评估;聋哑创伤患者未及时行腹腔穿刺或诊断性腹腔灌洗,漏诊小肠破裂及脓毒性休克等。我国应积极推进创伤分级救治体系建设,规范伤情评估策略和流程,是成功救治创伤患者的前提。The improved treatment for severe trauma needs the mastery of correct injury assessment strategies and techniques. By analyzing two cases of medical identification,this paper elaborates on misdiagnosis which may happen during in-hospital emergency treatment stages,including determining treatment strategies without the information about patient＇s hemodynamic status,being unable to clarify more valuable clinical manifestations for deaf patients,failing to timely perform abdominal paracentesis or diagnostic peritoneal lavage,failing to conduct effective assessment for chest trauma,un-appropriate secondary inspection process and strategy,lacking dynamic assessment for recovery,and miss-diagnosing septic shock,etc.

关 键 词：创伤和损伤 漏诊 肠穿孔 休克 脓毒性 

分 类 号：R641[医药卫生—外科学]