CAJ | 학술논문

目的探讨大批量地震伤员的早期救治方法.方法对1 123例地震伤员实施早期救治.受伤部位:四肢伤925例,脊柱伤65例,头部伤46例,胸部伤53例,腹部伤72例.单部位伤809例,多发伤314例.紧急手术67例,其中肝破裂修补13例,脾破裂行脾切除14例,肠系膜血管损伤修补3例,腹部多脏器损伤修补6例,胸腹联合伤行胸腹脏器损伤修补及膈肌破裂修补4例,颅内血肿清除术12例,肺破裂修补4例,肺及支气管部分切除5例,心脏压塞行心包切开1例,连枷胸行肋骨内固定5例.早期手术166例,其中早期单纯清创105例,清创加骨折外固定支架固定36例,截肢25例.结果 406例治愈出院,673例经初期治疗后转院治疗,死亡3例.结论分级救治方法适用于大批量地震伤员的早期救治.危重伤员及伴有严重心肺等基础疾病的地震伤员早期应采用损害控制技术.反复检诊是防止延误诊治的有效方法.
목적 탐토대비량지진상원적조기구치방법.방법 대1 123례지진상원실시조기구치.수상부위:사지상925례,척주상65례,두부상46례,흉부상53례,복부상72례.단부위상809례,다발상314례.긴급수술67례,기중간파렬수보13례,비파렬행비절제14례,장계막혈관손상수보3례,복부다장기손상수보6례,흉복연합상행흉복장기손상수보급격기파렬수보4례,로내혈종청제술12례,폐파렬수보4례,폐급지기관부분절제5례,심장압새행심포절개1례,련가흉행륵골내고정5례.조기수술166례,기중조기단순청창105례,청창가골절외고정지가고정36례,절지25례.결과 406례치유출원,673례경초기치료후전원치료,사망3례.결론 분급구치방법괄용우대비량지진상원적조기구치.위중상원급반유엄중심폐등기출질병적지진상원조기응채용손해공제기술.반복검진시방지연오진치적유효방법.
Objective To explore methods of easy treatment of bulk trauma patients caused by Wenchuan earthquake.Methods Early treatment was done on 1123 patients including extremity injuries in 925,spinal injuries in 65,brain injuries in 46,thoracic injuries in 53 and abdominal injuries in 72.There were 809 patients with single part injury and 314 with multiple injury.Emergent operation was performed in 67 patients including 13 with liver repair,14 with spleenectomy,three with mesentery blood vessel repair,six with repair of multiple abdominal organ injuries,four with repair of raptured diaphragm and injured organs,12 with evacuation of intracranial hematoma,four with lung repair,five with partial resection of lung and bronchus,one with pericardium discission and five with internal fixation of ribs.Early operation was carried out in 166 patients including 105 with only debridement,36 with debridement plus external fixation and 25 with amputation.Results Of all,406 patients were cured,673 were transferred to higher level hospitals after fundamental treatment and three died.Conclusion Staged treatment is suitable for early management for bulk trauma patients.Damage control technique should be applied early for critically severe patients and those with severe disease of heart and lung.Repeated examination is efficient to avoid delayed diagnosis and treament.