对地震挤压伤患者院前急救的反思与研讨_West China Medical Journal

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何庆 , 杨旻 , 姚蓉

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Keywords：

挤压伤; 挤压综合症; 院前急救; 地震

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目的:为挤压伤者的院前急救进行反思和研讨,提出一些新建议,以提高这类伤员的抢救成功率。材料和方法:本文特利用循证医学技术和方法,通过病例分析和文献回顾总结的方式。结果:通过文献回顾和病例分析,地震中挤压伤的院前处理应该注意以下几点:首先是重视早期补液的重要性,特别是液体的类型、量和补碱利尿时机;其次是局部患肢结扎,肢体处理和情绪的稳定;最后伤者获救后切忌盲目转运,现场分拣和急救后再转运。结论:应重视地震伤员院前急救过程中的规范化处理,以期最终改善预后,减少急性肾功衰和脓毒血症的发生,降低病残率和死亡率。

Citation： 何庆,杨旻,姚蓉. 对地震挤压伤患者院前急救的反思与研讨. West China Medical Journal, 2009, 24(4): 968-970. doi: Copy

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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. 努力提高脓毒症的认识水平[J].中国危重病急救医学, 2003, 15(3):1311. .
8.	马胜银, 刘朝阳. 连续性肾脏替代疗法在治疗伴急性肾功能衰竭的多器官功能障碍综合征中的应用[J]. 中国危重病急救医学, 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. 努力提高脓毒症的认识水平[J].中国危重病急救医学, 2003, 15(3):1311. .
8. 马胜银, 刘朝阳. 连续性肾脏替代疗法在治疗伴急性肾功能衰竭的多器官功能障碍综合征中的应用[J]. 中国危重病急救医学, 2003, 15(2):97991.

West China Medical Journal

对地震挤压伤患者院前急救的反思与研讨

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