原发性冲击伤的研究进展

Research progress on primary blast injury

无论在平时还是战时,冲击伤的发生率均有所增长,掌握冲击伤的发病规律及其救治策略是临床医师需要掌握的基本知识与技能。原发性冲击伤的基本特征是钝挫伤与穿透伤同时发生的多系统复合伤。密闭环境中的爆炸更容易引起原发性冲击伤。将鼓膜破裂作为判断严重原发性冲击伤标准是不准确的。肺部冲击伤出现较早,应该早期实施保护性肺通气。脑部冲击伤的发病较先前的报道有所增加。

Blast injuries have been increasing,whether in peacetime or in wartime. Clinicians need to understand the spectrum of injury and management strategies. Multisystem trauma associated with combined blunt and penetrating injuries are the basic features of primary blast injury. Explosions in closed spaces increase the possibility of primary blast injury. Rupture of tympanic membranes is an inaccurate marker for severe primary blast injury. Because blast lung injury manifests early,it should be managed with lung-protective ventilation. The incidence of blast brain injury is more common than previously reported.