群体烧伤伤员紧急空中转运及医学救援

Study on the medical service of air transportation and therapy for group burning patiennts of troops

目的 为了进一步研究群体烧伤病员的空中远距离转送及医疗救援的方法.方法 对2006年武警森林部队大兴安岭林区的35例烧伤患者,从现场救治、医疗转送到院内救治保障过程进行回顾分析.结果 卫勤保障按准备、检伤分类、现场急救、空中转送、后续治疗阶段逐步展开.全部伤员1 h内现场完成自救互救,并通过直升飞机及救护车转送到当地的医院进行急救;24 h后,由专机护送转北京治疗,空中飞行距离约1 600 km.35例烧伤患者,全部为男性,平均年龄24.06岁,烧伤面积在4%～65%,平均烧伤面积为16%,轻伤6人占17.14%,病重26人占74.29%,病危3人占8.57%.35例患者都合并吸入性气道损伤,重度吸入性损伤16人占45.71%,中度吸入性损伤19人占54.29%.全部伤员均治愈出院,无1例死亡.结论 森林火灾群体烧伤,大量合并气道吸入性损伤,现场急救非常困难;加强检伤分类与前接后送的管理,是群体伤员救治过程中防止混乱的基础;空中快速转运到后方医院接受最有效的专科治疗,可以提高救治成功率;空中医疗转送的医疗与护理具有独特性,但是相对安全;利用军队医疗转运力量及医疗救治力量实行跨军兵种卫勤力量的统筹使用,可以增强应急救援能力.

Objective To investigate the features of long distance air transportation and medical treatment after admission of group burn patients. Methods The clinical data on the diagnosis,transportation and treatment of thirty-five armed policemen of the Chinese Armed Police Forces Forest Troops who suffered from burn,Ⅱ°Ⅲ°,during the Great Xing’an Mountain Peak(Daxinganling)forest fire,all males,aged 24.06,was analyzed retrospectively. Results The average burn area was 16%(4% to 65%)Sixteen of them had mild burn(17.1%),26 had severe burn(74.3%),and 3 were in critical conditions(8.6%).All patients were complicated with inhalation injury,19(54.3%)with moderate inhalation injury,16(45.7%)with severe inhalation injury,and 13 having undergone incision of trachea.All the patients were transported by helicopter within one hour after the burn.13 patients received ventilation support,and the longest period with ventilation support was 21 days.The occurrence rate of wound infection was 45%. No patients died. Conclusion Inhalation injury is the most important complication that should be prevented during fighting the forest fire.Rapid air transportation to the strategic station hospital provides a chance for the burn patients to obtain specialized and effective treatment as early as possible.It helps improve the resaue ability tom use the military medical transportation and therapy power.