• 四川大學(xué)華西醫(yī)院急診醫(yī)學(xué)科,四川成都 610041;

目的:為擠壓傷者的院前急救進(jìn)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(yī)學(xué)技術(shù)和方法,通過(guò)病例分析和文獻(xiàn)回顧總結(jié)的方式。結(jié)果:通過(guò)文獻(xiàn)回顧和病例分析,地震中擠壓傷的院前處理應(yīng)該注意以下幾點(diǎn):首先是重視早期補(bǔ)液的重要性,特別是液體的類型、量和補(bǔ)堿利尿時(shí)機(jī);其次是局部患肢結(jié)扎,肢體處理和情緒的穩(wěn)定;最后傷者獲救后切忌盲目轉(zhuǎn)運(yùn),現(xiàn)場(chǎng)分揀和急救后再轉(zhuǎn)運(yùn)。結(jié)論:應(yīng)重視地震傷員院前急救過(guò)程中的規(guī)范化處理,以期最終改善預(yù)后,減少急性腎功衰和膿毒血癥的發(fā)生,降低病殘率和死亡率。

引用本文： 何慶,楊旻,姚蓉. 對(duì)地震擠壓傷患者院前急救的反思與研討. 華西醫(yī)學(xué), 2009, 24(4): 968-970. doi: 復(fù)制

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(rèn)識(shí)水平[J].中國(guó)危重病急救醫(yī)學(xué), 2003, 15(3):1311. .
8. 馬勝銀, 劉朝陽(yáng). 連續(xù)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(yīng)用[J]. 中國(guó)危重病急救醫(yī)學(xué), 2003, 15(2):97991.
  1. 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. 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. 3. BETTER O S. The crush syndrome revisited (1940-1990)[J]. Nephron,1990,55:97-103..
  4. 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. 5. VANHOLDER R, SEVER M S, EREK E, et al. Rhabdomyolysis[J]. J Am Soc Nephrol, 2000,11(8):1553-1561..
  6. 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. 7. 盛志勇. 努力提高膿毒癥的認(rèn)識(shí)水平[J].中國(guó)危重病急救醫(yī)學(xué), 2003, 15(3):1311. .
  8. 8. 馬勝銀, 劉朝陽(yáng). 連續(xù)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(yīng)用[J]. 中國(guó)危重病急救醫(yī)學(xué), 2003, 15(2):97991.