爆炸伤损伤机制与救治原则  

Mechanism and Treatment Principles of Blast Injuries

作　　者：周继红 吴鹏飞 袁丹凤 刘星 杨傲 ZHOU Ji-hong;WU Peng-fei;YUAN Dan-feng;LIU Xing;YANG Ao(Department of Military Traffic Medicine,Army specialty medical center of PLA,Chongqing 400042,China)

机构地区：[1]中国人民解放军陆军特色医学中心军事交通伤防治研究室,重庆400042

出　　处：《伤害医学(电子版)》2024年第4期63-67,共5页Injury Medicine(Electronic Edition)

摘　　要：爆炸伤是平战时的重要伤类,常伴着战争、冲突、意外爆炸事故而大批量产生。相对于传统的枪弹伤和创伤,爆炸伤更为特殊和复杂,防治更为困难。爆炸伤的损伤程度重、范围广、伤情空间分布上具有方向性,其致伤机制复杂,常同时合并多种损伤机制存在,如冲击伤、破片伤、撞击伤、烧伤、挤压伤等等。临床上爆炸伤多表现为复杂的复合伤、多部位多器官损伤,伴有复杂多变的病理生理过程,导致诊治极为困难。爆炸伤的发生具有群发特性,其批量伤员的高效科学救治需要有高效的卫勤组织指挥、卫勤保障支持。厘清爆炸伤主要损伤机制,抓住救治中关键环节,有助于我们进行高效、精准救治。Blast injuries constitute a significant type of injury during both peacetime and wartime,with large quantities of injuries in the wake of wars,conflicts,and accidental explosions.In contrast to traditional gunshot wounds and traumas,blast injuries are more distinctive and complex,thereby making their prevention and treatment more challenging.Blast injuries are marked by severe damage,extensive injury scope,and a directional spatial distribution of injuries.Their injury mechanisms are intricate,often encompassing multiple injury mechanisms via impact,fragmentation,crush,burns,and compression.Clinically,blast injuries typically manifest as complex combined injuries involving multiple organs and body parts,and complex and variable pathophysiological processes,which render diagnosis and treatment highly arduous.Blast injuries have a clustered occurrence pattern,and efficient and scientific treatment of a large number of casualties demands effective medical organization and logistical support.Clarifying the main injury mechanisms of blast injuries and concentrating on key treatment steps can assist us in providing efficient and precise treatment.

关 键 词：爆炸伤 复合伤 多发伤 急救 治疗 

分 类 号：R826[医药卫生—临床医学]