肺爆震伤临床救治指南(2023版)  

Clinical treatment guideline for pulmonary blast injury(version 2023)

作　　者：宋志明[1] 郭军华[1] 陈检明[1] 钟京[1] 窦燕[1] 孟加榕[1] 张国民[1] 刘国栋 梁华平 陈和忠 许硕贵 张宇峰 王志农 钟代星 姜涛 薛志强[6] 周飞虎[6] 梁志欣[6] 刘阳[6] 吴旭[7] 蔡开灿[7] 申翼 宋勇 苑小历 徐恩五 郑轶峰 王述民 郗二平 杨胜生 蔡文科 陈瑜 李庆新 邹志强 苏畅 商宏伟 徐降兴 刘永靖 王前进 魏小东 许国安 刘高峰 罗俊辉 李庆华 宋斌 郭明 黄郴[29] 徐驯宇[29] 涂远荣[30] 郑理玲[31] 段明科 万仁平 于腾波 余海 赵艳梅 魏玉萍 张进 郭华 蒋建新 张连阳 易云峰[1] 中华医学会创伤学分会 《中华创伤杂志》编辑委员会 Song Zhiming;Guo Junhua;Chen Jianming;Zhong Jing;Dou Yan;Meng Jiarong;Zhang Guomin;Liu Guodong;Liang Huaping;Chen Hezhong;Xu Shuogui;Zhang Yufeng;Wang Zhinong;Zhong Daixing;Jiang Tao;Xue Zhiqiang;Zhou Feihu;Liang Zhixin;Liu Yang;Wu Xu;Cai Kaican;Shen Yi;Song Yong;Yuan Xiaoli;Xu Enwu;Zheng Yifeng;Wang Shumin;Xi Erping;Yang Shengsheng;Cai Wenke;Chen Yu;Li Qingxin;Zou Zhiqiang;Su Chang;Shang Hongwei;Xu Jiangxing;Liu Yongjing;Wang Qianjin;Wei Xiaodong;Xu Guoan;Liu Gaofeng;Luo Junhui;Li Qinghua;Song Bin;Guo Ming;Huang Chen;Xu Xunyu;Tu Yuanrong;Zheng Liling;Duan Mingke;Wan Renping;Yu Tengbo;Yu Hai;Zhao Yanmei;Wei Yuping;Zhang Jin;Guo Hua;Jiang Jianxin;Zhang Lianyang;Yi Yunfeng(909th Hospital of Joint Logistics Support Force of PLA,Dongnan Hospital of Xiamen University,Zhangzhou 363000,China;Medical Center of Trauma and War Injury,National Key Laboratory of Trauma and Chemical Poisoning,Army Medical Center,Chongqing 400042,China;First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Second Affiliated Hospital of Air Force Medical University,Xi′an 710038,China;General Hospital of PLA,Beijing 100853,China;Southern Hospital of Southern Medical University,Guangzhou 510515,China;General Hospital of Eastern Theater Command,Nanjing 210002,China;General Hospital of Southern Theater Command,Guangzhou 510010,China;General Hospital of Western Theater Command,Chengdu 610083,China;General Hospital of Northern Theater Command,Shenyang 110016,China;General Hospital of Central Theater Command,Wuhan 430064,China;900th Hospital of Joint Logistics Support Force of PLA,Fuzhou 350003,China;920th Hospital of Joint Logistics Support Force of PLA,Kunming 650032,China;940th Hospital of Joint Logistics Support Force of PLA,Lanzhou 730070,China;960th Hospital of Joint Logistics Support Force of PLA,Jinan 250031,China;980th Hospital of Joint Logistics Support Force of PLA,Shijiazhuang 050001,China;983rd Hospital of Joint Logistics Support Force of P

机构地区：[1]解放军联勤保障部队第九〇九医院,厦门大学附属东南医院,漳州363000 [2]陆军特色医学中心战创伤医学中心,创伤与化学中毒全国重点实验室,重庆400042 [3]海军军医大学第一附属医院,上海200433 [4]海军军医大学第二附属医院,上海200003 [5]空军军医大学第二附属医院,西安710038 [6]中国人民解放军总医院,北京100853 [7]南方医科大学附属南方医院,广州510515 [8]解放军东部战区总医院,南京210002 [9]解放军南部战区总医院,广州510010 [10]解放军西部战区总医院,成都610083 [11]解放军北部战区总医院,沈阳110016 [12]解放军中部战区总医院,武汉430064 [13]解放军联勤保障部队第九〇〇医院,福州350003 [14]解放军联勤保障部队第九二〇医院,昆明650032 [15]解放军联勤保障部队第九四〇医院,兰州730070 [16]解放军联勤保障部队第九六〇医院,济南250031 [17]解放军联勤保障部队第九八〇医院,石家庄050001 [18]解放军联勤保障部队第九八三医院,天津300381 [19]解放军联勤保障部队第九〇七医院,南平353000 [20]解放军联勤保障部队第九〇一医院,合肥230061 [21]解放军联勤保障部队第九〇二医院,蚌埠233000 [22]解放军联勤保障部队第九〇四医院,无锡214041 [23]解放军联勤保障部队第九〇八医院,鹰潭335000 [24]解放军联勤保障部队第九八八医院,郑州450007 [25]解放军联勤保障部队第九八九医院,洛阳471003 [26]解放军联勤保障部队第九九〇医院,驻马店463000 [27]陆军第七十二集团军医院,湖州313000 [28]陆军第七十三集团军医院,厦门361007 [29]福建省立医院,福州350001 [30]福建医科大学附属第一医院,福州350005 [31]福建医科大学附属泉州第一医院,泉州362000 [32]厦门医学院附属海沧医院,厦门361026 [33]汕头大学医学院附属粤北人民医院,韶关512026 [34]康复大学青岛医院(青岛市立医院)东院区,青岛266071 [35]陆军厦门特勤疗养

出　　处：《中华创伤杂志》2023年第12期1057-1069,共13页Chinese Journal of Trauma

基　　金：国家重点研发计划(2023YFC3011801);军队后勤科研项目(CWH17J030);军队高层次科技创新人才工程人选自主科研项目(联战(2022)151);国防基础加强重点项目(2022-JCJQ-ZD-224-12);科技部国家重点研发计划青年科学家项目(2022YFB3808000)。

摘　　要：肺爆震伤已成为现代战创伤中主要伤类,具有外轻内重、病情发展迅速及早期病死率高等特点。其伤情复杂,多发伤和复合伤多,目前无有效的防护材料,少有精准的出血检测仪器和轻便的监测转运设备等,各临床医疗中心没有标准的救治规范,国内外缺乏具有循证医学证据的指南,从而导致肺爆震伤的病死率较高。因此,中华医学会创伤学分会和《中华创伤杂志》编辑委员会组织军内外胸外科和创伤外科等相关领域的专家,综合有效证据和临床一线救治经验,共同制订《肺爆震伤临床救治指南(2023版)》,就肺爆震伤的定义和特点、院前诊断和救治及院内救治等提出16条推荐意见,为各级医院开展临床救治提供依据。Pulmonary blast injury has become the main type of trauma in modern warfare,characterized by externally mild injuries but internally severe injuries,rapid disease progression,and a high rate of early death.The injury is complicated in clinical practice,often with multiple and compound injuries.Currently,there is a lack of effective protective materials,accurate injury detection instrument and portable monitoring and transportation equipment,standardized clinical treatment guidelines in various medical centers,and evidence-based guidelines at home and abroad,resulting in a high mortality in clinlcal practice.Therefore,the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury(version 2023)by combining evidence for effectiveness and clinical first-line treatment experience.This guideline provided 16 recommended opinions surrounding definition,characteristics,pre-hospital diagnosis and treatment,and in-hospital treatment of pulmonary blast injury,hoping to provide a basis for the clinical treatment in hospitals at different levels.

关 键 词：爆震伤 肺 胸部损伤 指南 

分 类 号：R655.3[医药卫生—外科学]