“5.12”汶川大地震重症伤员特征与分阶段救治
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摘要
目的总结汶川大地震重症伤员的特征及分阶段救治的经验。方法通过对伤员和重症的分类统计和数据分析,掌握不同阶段重症伤员的分布特征,从而有计划有针对性地实施分阶段救治。结果"5.12"汶川地震后收治的重症伤员主要包括脊柱骨折合并脊髓损伤、颅脑外伤、截瘫、截肢、挤压综合征、四肢及骨盆外伤、耐药性感染、多器官功能衰竭。在救治过程拟定分三个阶段救治措施,提高了危重症患者的救治成功率。第一阶段抢救挤压综合征和急性肾功能衰竭,第二阶段解决伤员多器官功能衰竭和复杂耐药性感染,第三阶段实行"四集中",即实施"集中伤员、集中专家、集中支撑条件、集中收治"的工作方案,降低了死亡率。结论大地震后重症伤员特征的分析和分阶段科学救治是最大限度地降低伤员病死率,挽救伤员生命的关键。
[Objective] To summarize the characteristics of severe cases in Wenchuan megaseism and the experience of staged rescue. [Methods] The distributing characteristics of severe cases in different stages were obtained by means of classification statistic and data analysis of the wounded and serious diseases, accordingly staged rescue was performed designedly and definitely. [Results] After"5.12" Wenchuan megaseism,the hospitalized severe cases included mainly spine fracture combined with spinal injury, craniocerebral trauma, paraplegia, amputation, crush syndrome, limbs and pelvis injury, drug resistant infection, multiple organ failure and so on. Remedy achievement ratio in dangerous and severe cases was increased by three-stage rescuing measures. In the first stage, crush syndrome and acute renal failure(ARF) were rescued. In the second stage, multiple organ failure and complex drug resistant infection were treated. In the third stage,"four-collection" scheme, which meaned collection of the wounded, experts, essential condition and management, was performed with low mortality. [Conclusion] Characteristic analysis of severe cases and scientific staged rescue after megaseism are crucial to save the lives of the wounded and consequently depress the mortality maximatily.
[Objective] To summarize the characteristics of severe cases in Wenchuan megaseism and the experience of staged rescue. [Methods] The distributing characteristics of severe cases in different stages were obtained by means of classification statistic and data analysis of the wounded and serious diseases, accordingly staged rescue was performed designedly and definitely. [Results] After"5.12" Wenchuan megaseism,the hospitalized severe cases included mainly spine fracture combined with spinal injury, craniocerebral trauma, paraplegia, amputation, crush syndrome, limbs and pelvis injury, drug resistant infection, multiple organ failure and so on. Remedy achievement ratio in dangerous and severe cases was increased by three-stage rescuing measures. In the first stage, crush syndrome and acute renal failure(ARF) were rescued. In the second stage, multiple organ failure and complex drug resistant infection were treated. In the third stage,"four-collection" scheme, which meaned collection of the wounded, experts, essential condition and management, was performed with low mortality. [Conclusion] Characteristic analysis of severe cases and scientific staged rescue after megaseism are crucial to save the lives of the wounded and consequently depress the mortality maximatily.
引文
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[2]JI Q,SONG J,ZHAO Q,et al.Clinical comprehensive treatment of severe traumatic brain injury with wet lung in52cases[J].China Journal of Modern Medicine,2007,17(7):877-878,882.Chinese
[3]WANG JS.Experience of diagnosis and treatment in206cases with severe chest trauma with multiple injury[J].China Journal of Modern Medicine,2005,15(3):462-463.Chinese
[4]VANHOLDER R,SEVER MS,EREK E,et al.Acute renal fail-ure related to crush syndrome:towards an era of seismo-nephrol-ogy[J].Nephrol Dial Transplant,2000,15:1517-1521.
[5]SHAO LX,SHEN BM,JIN W,et al.Characteristics and emer-gency treatment of multiple organ disorder syndrome following severe thoracic trauma[J].China Journal of Modern Medicine,2006,16(19):3162-3164.Chinese
[6]CHAN YF,ALAGAPPAN K.Disaster management following the Chi-Chi earthquake in Taiwan[J].Prehosp Disaster Med,2006,21(3):196-202.
[7]LIU SZ,WANG SA.Difficulties and strategies of resisting the disaster from the earthquake in Zhangbei and Shangyi regions and ensuring medical service[J].Forum of National Defense and Medical Science,1998,7(22):8.Chinese
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