严重创伤救治若干新进展

Some new progress in the treatment of severe trauma

随着创伤事件日渐增多,形成有效的救治策略以提高对严重创伤的综合反应能力越来越受重视。在不影响结局的前提下,遵循标准化的评估策略对创伤进行评估能高效率的实现早期的明确诊断。对于有活动性出血的创伤失血性休克建议损伤控制限制性液体复苏,同时应早期识别和重视创伤凝血病的发生。对血流动力学不稳定骨盆骨折的处理,应能实现有效的止血,且重视多学科团队协作在其中的作用。各创伤机构应能发挥自身优势,建立区域创伤救治体系,组建一支高素质的专业队伍,最终提高严重创伤的救治水平。

With the development of efficient strategies for the treatment of severe trauma, enhancing the ability of associated comprehensive reactions has been increasingly appreciated with the fast-growing trauma events. A standardized strategy for trauma assessment is helpful and efficient for early and definite diagnosis. For bleeding trauma patients with hemorrhagic shock, limited fluid resuscitation is recommended to decrease physical derangements before definite hemostasis. It＇s essential to identify and manage acute, traumatic coagulopathy in the very early stage. Control of bleeding resources plays pivotal role in the outcome of hemodynamically unstable pelvic fractures, treatment decisions should be based on multidisciplinary teamwork. Trauma centers are mandated to improve their ability of responses to severe trauma , by making use of their conventional advantages and developing regional trauma systems and multi-professional trauma teams.