严重腹部交通伤患者院前集束化急救策略研究

Study on pre-hospital emergency clustering strategy for patients with severe abdominal traffic injuries

重度交通伤患者中多达20%的患者被诊断有严重腹部创伤,并且有高达20%的病死率。严重出血是导致死亡的主要原因,但随着医疗技术及设备的发展,目前腹部创伤引起的出血被认为是潜在的可预防性死亡。本研究以“战伤救治理念体系”为依据,集合了包括创伤重点超声评估、腹腔内止血复苏、院前输血等一系列有循证基础的诊疗干预措施,制定院前集束化救治策略,更好地指导严重腹部交通创伤患者的院前急诊救治,以期望延长其有效救治时间窗,为后续的院内治疗创造条件,并且提高患者在院内手术时的耐受力,从而降低创伤患者的病死率。

Among severe patients with road traffic injuries,up to 20%of them are diagnosed to have severe abdominal trauma,with the morbidity and mortality rate as high as 20%.Massive bleeding is a major cause of death.With the advanced development in rescue techniques and equipment,bleeding following abdominal trauma is now believed to be potentially preventable.Based on the concept of"damage control",this study summarizes a series of evidence-based pre-hospital treatment interventions,including trauma-focused ultrasound assessment,resuscitative endovascular balloon occlusion,permissive hypotension,hemostatic resuscitation and surgical damage control.With the aid of the online platform,it is hoped to better guide the pre-hospital emergency care of severe abdominal trauma patients following road traffic accidents,and to extend the effective therapeutic time window,create better preparations for subsequent in-hospital management,and improve the patient’s tolerance for in-hospital surgeries,all of which are supposed to decrease the morbidity and mortality rate of such patients.