對地震擠壓傷患者院前急救的反思與研討_West China Medical Journal

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何慶 , 楊旻 , 姚蓉

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Keywords：

擠壓傷; 擠壓綜合癥; 院前急救; 地震

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目的:為擠壓傷者的院前急救進行反思和研討,提出一些新建議,以提高這類傷員的搶救成功率。材料和方法:本文特利用循證醫學技術和方法,通過病例分析和文獻回顧總結的方式。結果:通過文獻回顧和病例分析,地震中擠壓傷的院前處理應該注意以下幾點:首先是重視早期補液的重要性,特別是液體的類型、量和補堿利尿時機;其次是局部患肢結扎,肢體處理和情緒的穩定;最后傷者獲救后切忌盲目轉運,現場分揀和急救后再轉運。結論:應重視地震傷員院前急救過程中的規范化處理,以期最終改善預后,減少急性腎功衰和膿毒血癥的發生,降低病殘率和死亡率。

Citation： 何慶,楊旻,姚蓉. 對地震擠壓傷患者院前急救的反思與研討. West China Medical Journal, 2009, 24(4): 968-970. doi: Copy

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6.	BETTER O S. Rescue and salvage of casualties suffering from the crush syndrome after mass disasters[J]. Mil Med,1999, 164:366-369. .
7.	盛志勇. 努力提高膿毒癥的認識水平[J].中國危重病急救醫學, 2003, 15(3):1311. .
8.	馬勝銀, 劉朝陽. 連續性腎臟替代療法在治療伴急性腎功能衰竭的多器官功能障礙綜合征中的應用[J]. 中國危重病急救醫學, 2003, 15(2):97991.

1. VANHOLDER R, SEVER M S, EREK E, et al. Acute renal failure related to crush syndrome:towards an era of seismo-nephrology[J]? Nephrol Dial Transplant, 2000,15:1517-1521..
2. SEVER M S, VANHOLDER R, LAMEIRE N. Management of crush-related injuries after disasters[J]. N Engl J Med, 2006,354,1052-1063..
3. BETTER O S. The crush syndrome revisited (1940-1990)[J]. Nephron,1990,55:97-103..
4. RAMIN T, DOROTHEA W, MOHAMMAD HL, et al. Oral alkalinizing solution as a potential prophylaxis againstmyoglobinuric acute renal failure:preli minary data from healthy volunteers[J]. Nephrol Dial Transplant,2005,20:1228-1231..
5. VANHOLDER R, SEVER M S, EREK E, et al. Rhabdomyolysis[J]. J Am Soc Nephrol, 2000,11(8):1553-1561..
6. BETTER O S. Rescue and salvage of casualties suffering from the crush syndrome after mass disasters[J]. Mil Med,1999, 164:366-369. .
7. 盛志勇. 努力提高膿毒癥的認識水平[J].中國危重病急救醫學, 2003, 15(3):1311. .
8. 馬勝銀, 劉朝陽. 連續性腎臟替代療法在治療伴急性腎功能衰竭的多器官功能障礙綜合征中的應用[J]. 中國危重病急救醫學, 2003, 15(2):97991.

West China Medical Journal

對地震擠壓傷患者院前急救的反思與研討

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