大型恐怖爆炸事件伤情谱特征研究  

Injury spectrum of mass casualty terrorist bombing events

作　　者：王玥 严文韬 江雷 秦超 Wang Yue;Yan Wentao;Jiang Lei;Qin Chao(Department of Military Health Service,Faculty of Military Health Service,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学卫生勤务学系卫生勤务学教研室,上海200433

出　　处：《创伤外科杂志》2024年第9期647-654,共8页Journal of Traumatic Surgery

摘　　要：目的分析大型恐怖爆炸事件伤情谱,为提高应急救援能力提供参考和依据。方法检索中国知网、万方、维普、Pubmed、Web of Science、Cochrane Database等数据库,收集并筛选建库至2023年12月31日全世界伤亡人数>100人的大型恐怖爆炸事件相关文献,从伤类、伤部、手术、死亡原因等方面进行系统性分析。结果本研究共纳入32起恐怖爆炸事件,共计伤亡人数16826人,其中伤员数量6602人,爆炸伤伤情13636个,手术事件1003个。32起事件平均致死率15.11%,当发生建筑物坍塌时致死率会升高。致伤类型:穿透伤/撕裂伤(35.59%),挫伤/擦伤(23.81%),骨折(6.69%),耳爆震伤(6.41%)。致伤部位:头面颈部(35.78%)与四肢(33.26%)的伤情占比高,胸背部第3位(10.98%),上肢数量(12.20%)少于下肢(16.40%)。现场幸存者大多为轻伤,平均住院率为25.6%,重症患者(ISS≥16分)数量占幸存伤员的7.76%、住院治疗患者的25.55%,重症患者的病死率为23.14%。入院手术大部分为软组织相关手术(47.86%),其次为骨科(23.23%)、腹部(14.86%)、胸部(6.18%)相关手术。重伤患者治疗后死亡原因以严重头部创伤及多部位伤为主,按部位依次是头部(40.85%)、胸部(26.76%)、腹部(18.31%)、四肢(14.08%)。大多数死亡病例发生在入院48 h以内,主要死因是严重头部创伤、胸腹部穿透伤与失血性休克;入院1周后的主要死因是烧伤、感染与多脏器衰竭。结论由于恐怖爆炸伤员入院后主要死亡原因是头部、胸部的严重创伤,手术主要以软组织相关手术为主,建议在收治大批量恐怖爆炸伤员时选派颅脑外科、胸外科和重症医学专家对危重伤员进行重点救治,以普外科、骨科为主要收治科室。Objective To analyze the injury spectrum of mass casualty terrorist bombing events,and to provide a theoretical basis for improving emergency rescue capacity.Methods Worldwide literature on mass casualty terrorist bombing events(defined as>100 casualties)published until Dec.31st,2023 was collected from the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and Cochrane Database.The injury types,injury sites,surgeries,and causes of death were systematically analyzed.Results A total of 32 mass casualty terrorist bombings events were included in this study,with 16,826 casualties(including 6,602 wounded and 13,636 blast injuries,and 1003 surgical events).The average fatality rate of the 32 mass casualty events was 15.11%,which became higher when building collapse occurred.The injury types were mainly penetrating/tear injuries(35.59%),contusion/abrasion(23.81%),fractures(6.69%),and ear blast injuries(6.41%).In terms of injury sites,head and neck(35.78%)and limbs(33.26%)accounted for the highest proportion,with chest and back(10.98%)ranking third.For limb injuries,the upper limb was less commonly affected than the lower limb(12.20%vs.16.40%).Most of the survivors had minor injuries,with an average hospitalization rate of 25.6%.Severely injured patients(defined as ISS≥16)accounted for 7.76%of the surviving wounded,while 25.55%of the hospitalized patients.The mortality rate of severely injured patients was 23.14%.Most of the in-hospital surgeries were soft tissue-related(47.86%),followed by orthopedic-related(23.23%),abdomen-related(14.86%),and chest-related(6.18%).The main causes of death in the severely injured patients after treatment were critical head trauma and multiple injuries,with the injury regions of head(40.85%),chest(26.76%),abdomen(18.31%)and limbs(14.08%)in sequence.Most deaths occurred within 48 h after admission,due to severe head trauma,penetrating chest and abdominal injuries and hemorrhagic shock;while the 1-week hospital deaths were mainly due to burns,infections,and multiple organ failure.Conclus

关 键 词：恐怖爆炸 大规模伤亡事件 致伤类型 致伤部位 手术 死亡原因 

分 类 号：R826.1[医药卫生—临床医学]