爆炸冲击伤的诊断

Diagnosis of explosive blast injury

爆炸冲击伤是爆炸后冲击波超压直接作用机体,因释放能量而产生的各种损伤,属原发性爆炸伤。爆炸冲击伤表现外轻内重,多发伤、复合伤多见,脏器挫伤重,伤情发展迅速,诊断难度大。本文详细介绍了爆炸伤的分类及爆炸冲击伤的致伤机制,肺、胃肠道和耳爆炸冲击伤的临床表现,X线片、CT和超声检查,动脉血气以及耳镜及电耳镜、听功能和前庭功能等检查手段,并阐述了常见爆炸冲击伤的诊断要点。

Explosive blast injury is caused by shock waves that directly harm the body and energy released after explosion. It is a kind of primary explosive injury. Explosive blast injury manifests itself as seemingly slight but actually severe. Multiple injuries and combined injuries are common and viscera contusions are severe. Injuries develop rapidly and are difficult to be diagnosed. In this paper,the classification and mechanism of explosive blast injury,clinical features of blast injury in lung,gastrointestinal tract and ear,examination with X-ray,CT and ultrasound,along with inspections such as arterial blood gas,otoscope,electric auriscope,auditory function and vestibule function were explicitly introduced. Meanwhile,key points in the diagnosis of explosive blast injury were also stated.