多发性创伤52例院前急救与护理

我院急救中心2001年12月～2007年12月院前共抢救52例多发性创伤患者,现总结报告如下.1 临床资料1.1 一般资料本组52例,男43例,女9例;年龄7～76岁;严重程度评分(ISS)16～50.院前30 min 17例,30 min～1 h 20例,1～2 h 6例,2～3 h 4例,3 h以上5例.

严重多发伤院前急救的护理配合

随着我国经济建设、交通、旅游等事业的飞速发展,被称为世界第一公害的交通事故直线上升,严重多发伤正在逐年增加.我国每年因创伤致死的人数至少有10余万人,致伤数百万[1].

重型颅脑损伤伴严重复合伤的紧急救治(附12例分析)

我科1999年6月至2002年3月共收治12例重型颅脑损伤伴严重复合伤(Severe head injury with severe multiple trauma, SHIWSMT)患者,占同期重型颅脑损伤的12.2%(12/98),本文对SHIWSMT抢救治疗结果进行回顾性分析,现报告如下.

以腹部为主的多发性损伤53例诊治体会

目前，交通事故伤的死亡率每年以10％的速度递增，已成为我国城市成人人群主要死因。我院1991年至1999年间收治53例以腹部创伤为主的多发性损伤病例，现对其诊断、治疗的体会报告如下。 1 临床资料 1．1一般资料 53例中男性45例，女性8例。年龄：2岁至68岁，其中18岁至40岁占82％。受伤驾驶员4人，乘客36人，行人及其他13人。伤后就诊时间1.5小时至7天。 1．2 临床表现 腹痛50例，失血性休克36例，昏迷3……

多发伤的致伤机制与紧急救治原则

多发伤初指累及不同解剖部位的复杂创伤,有多个伤口.现代多发伤是指机体在单一机械致伤因素作用下,同时或相继遭受两个或两个以上解剖部位的创伤,其中至少有一处较严重.所谓解剖部位指按AIS-2005版划分的头颈部、面部、胸部(包括胸椎、膈肌和肋骨架)、腹部(包括腰椎、盆腔)、四肢和体表等6个部位.

多发伤救治的损伤控制策略

多发性创伤患者初治疗的首要目的是通过优先复苏让患者生存并有感知功能,如果创伤的严重性不允许,存在终手术不能马上进行的情况,而在综合复苏过程中运用损伤控制(damage control,DC)策略既能有效控制原发创伤,又能积极预防继发性损害,是近年来提高严重多发伤患者抢救成功率的有效尝试之一.

Objective: To establish the device and model of motorcyclist ejection injury.Methods: Based on our laboratory devices, a motorcy-clist ejection injury simulation system was developed.A total of 18 pigs were approved by the local animal experi-mentation and ethics committee to serve as the motorcy-clist substitutes.In this ejection motion, the animal rode freely at the motor driver seat and was straightly acceler-ated by means of our custom motorcyclist ejection injury simulation system.When it was speeded up to the preset velocity (v=30, 40 or 50 kin/h) at the preset position, the animal was ejected forward.Pathological and dynamic analy-ses were conducted, accompanied with the high-speed photograph, acceleration/velocity signal test, gross obser-vation and light microscope examination as well as the ab-breviated injury score-injury severity score (AIS-ISS) scale.Results: The high-speed photograph indicated that during the ejection procedure the motorcycle was first ar-rested and decelerated suddenly, and then the motorcycle driver was ejected forward, accompanied with the rotation motion in the air.Finally, the head, shoulder and thorax of the ejected animal impacted directly on the hard ground.Varying degrees of injury focusing on the liver, heart, lung and spleen were found.There existed a significant positive, correlation between ISS and the ejection velocity of the motorcycle drivers (ISS=16.7+2.9 for 30 kin/h, 25.0±0.0 for 40 km/h and 37.3a=1.0 for 50 kin/h), The detailed injury char-acteristics were as follows: for the mildly injured animals, there were interlobar gaps or leaf gaps and lobar surface blood coagulation blocks in the liver, and mild lung hemorrhage; for the severely injured animals, there were liver comminuted laceration, moderate lung hemorrhage and heart injury.Animals suffering from the most severe injuries died half an hour later.Conclusion: The new injury model stated in this paper has a high stability and good repeatability, and is likely to be helpful to deeply investigate the injury mechanisms and protection countermeasures of motorcyclist ejection injury.