平时火器伤的流行病学特征及救治
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摘要
目的分析平时火器伤的流行病学特征及救治特点,为医务人员改善火器伤的医疗救治水平提供科学性建议。方法通过调查15例平时火器伤患者的病历数据,利用描述性统计方法进行分析。结果平时火器伤中男女比例为6.5∶1,高发人群为35～44岁和15～24岁。头部是最常见的伤部,异物存留的发生比例为46.7%。火器伤患者中皮肤软组织损伤的发生率为100.0%,骨折和骨关节损伤以及中枢神经系统损伤的发生比例分别为40.0%和13. 0%。火器伤患者中重伤和危重伤所占比例分别为6.7%和13.3%。患者院前时间和住院天数普遍较长,53. 3%的患者治愈出院。结论火器伤的防控和救治时应综合考虑人口学特征、受伤特征和创伤救治因素,关注头部创伤和多发伤救护,缩短院前时间,早期预测和防治失血性休克和意识障碍等并发症。
Objective This study was aimed to analyze the epidemiological characteristics and treatment strategies of firearm injury in peacetime, and provide scientific suggestions for medical staff to improve the treatment of firearm injury patients. Methods 15 firearm injury patients were investigated, and the descriptive statistical analysis method was used to analyze the data. Results Among the firearm injury patients, the male to female rate was 6. 5 ∶ 1. And the population between 35-44 years old and 15-24 years old had a high incidence of injury. Head was the most common injury region, and the incidence of foreign body survival was 46. 7%. The incidence of soft tissue injury was 100. 0% in firearm injury patients, and fracture and bone and joint injury and central nervous system injury were accounted for 40. 0% and 13. 0%, respectively. The proportions of serious injured patients and critically injured patients among firearm injury patients were 6. 7% and 13. 3%, respectively. The pre-hospital time and length of stay of firearm injury patients were generally long, and 53. 3% of firearm injured patients were cured. Conclusion The prevention and treatment of firearm injury patients should consider the demographic fac-tors, injured factors and treatment factors. The medical staff should focus on the rescue of firearm injury patients with head injuries or multiple injuries, shorten the pre-hospital time, and predict and prevent the hemorrhagic shock and disturbance of consciousness early.
Objective This study was aimed to analyze the epidemiological characteristics and treatment strategies of firearm injury in peacetime, and provide scientific suggestions for medical staff to improve the treatment of firearm injury patients. Methods 15 firearm injury patients were investigated, and the descriptive statistical analysis method was used to analyze the data. Results Among the firearm injury patients, the male to female rate was 6. 5 ∶ 1. And the population between 35-44 years old and 15-24 years old had a high incidence of injury. Head was the most common injury region, and the incidence of foreign body survival was 46. 7%. The incidence of soft tissue injury was 100. 0% in firearm injury patients, and fracture and bone and joint injury and central nervous system injury were accounted for 40. 0% and 13. 0%, respectively. The proportions of serious injured patients and critically injured patients among firearm injury patients were 6. 7% and 13. 3%, respectively. The pre-hospital time and length of stay of firearm injury patients were generally long, and 53. 3% of firearm injured patients were cured. Conclusion The prevention and treatment of firearm injury patients should consider the demographic fac-tors, injured factors and treatment factors. The medical staff should focus on the rescue of firearm injury patients with head injuries or multiple injuries, shorten the pre-hospital time, and predict and prevent the hemorrhagic shock and disturbance of consciousness early.
引文
[1]李兵仓.现代火器伤研究概览[J].临床外科杂志, 2007, 15(11):792-793.
[2]昌耘冰,尹庆水.不同初期外科处理方法治疗平时四肢火器伤的应用和比较[J].中国现代医学杂志,2002,12(1):44-46.
[3]Mortality G, Collaborators COD. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240causes of death, 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet 2015, 385(9963):117-171.
[4]Le Garff E, Delannoy Y, Mesli V, Berthezene JM, Morbidelli P,Hedouin V. Homemade Firearm Suicide With Dumbbell Pipe Triggering by an Air-Compressed Gun:Case Report and Review of Literature[J]. The American journal of forensic medicine and pathology, 2015, 36(4):257-261.
[5]Crandall M, Eastman A, Violano P, Greene W, Allen S, Block E, et al. Prevention of firearm-related injuries with restrictive licensing and concealed carry laws:An Eastern Association for the Surgery of Trauma systematic review[J]. The journal of trauma and acute care surgery, 2016, 81(5):952-960.
[6]王正国.多发伤的救治[J].中华创伤杂志, 2004, 20(1):1-3.
[7]王正国.王正国创伤外科学[M].上海:上海科学技术出版社, 2002:1-60.
[8]Faulkenberry J G, Schaechter J. Reporting on pediatric unintentional firearm injury:who.s responsible[J]. The journal of trauma and acute care surgery, 2015, 79(3):2-8.
[9]Weiner J, Wiebe D J, Richmond T S, Beam K, Berman AL, Branas CC, et al. Reducing firearm violence:a research agenda[J].Injury prevention:journal of the International Society for Child and Adolescent Injury Prevention 2007, 13(13):80-84.
[10]赵彬,李兵仓.火器伤后遗留的金属异物对人体危害的研究进展[J].解放军医学杂志,2002, 27(12):1123-1124.
[11]Lapostolle F, Borron S W, Gere C, Dallemagne F, Beruben A,Lapandry C, et al. Victims of fall from height. Study of 287 patients and determination of clinical prognostic factors[J]. Annales Franaises Danesthèsie Et De Rèanimation 2004, 23(7):689-693.
[12]周正东,陈训如,卫仕臣. 281例腹部火器伤的诊治[J].中华创伤杂志, 2000,16(6):373-375.
[13]田志强,赵东海,李全岳,等.腹部火器伤131例临床救治分析(附9例尸检资料)[J].中国伤残医学, 2009,17(6):11-13.
[14]P?yry T, Luoto TM, Kataja A, Brander A, Tenovuo O, Iverson GL, et al. Acute assessment of brain injuries in ground-level falls[J]. Journal of Head Trauma Rehabilitation, 2013, 28(2):89-97.
[15]惠纪元. 11937例急性颅脑创伤病人的预后因素分析[D].上海:上海交通大学, 2015:40-70.
[16]赵东华,刘兴炎,葛宝丰,等.负压封闭引流联合灌洗治疗感染软组织火器伤早期疗效的初步实验观察[J].创伤外科杂志,2011,13(4):340-343.
[17]汪月忠,叶志弘,同俏静,等.院内感染控制和预防的精细化管理[J].中华医院管理杂志, 2012, 28(3):234-236.
[18]黄耀添,马平,侯黎升,等.火器性四肢动脉伤[J].中华骨科杂志, 1997(2):110-112.
[2]昌耘冰,尹庆水.不同初期外科处理方法治疗平时四肢火器伤的应用和比较[J].中国现代医学杂志,2002,12(1):44-46.
[3]Mortality G, Collaborators COD. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240causes of death, 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet 2015, 385(9963):117-171.
[4]Le Garff E, Delannoy Y, Mesli V, Berthezene JM, Morbidelli P,Hedouin V. Homemade Firearm Suicide With Dumbbell Pipe Triggering by an Air-Compressed Gun:Case Report and Review of Literature[J]. The American journal of forensic medicine and pathology, 2015, 36(4):257-261.
[5]Crandall M, Eastman A, Violano P, Greene W, Allen S, Block E, et al. Prevention of firearm-related injuries with restrictive licensing and concealed carry laws:An Eastern Association for the Surgery of Trauma systematic review[J]. The journal of trauma and acute care surgery, 2016, 81(5):952-960.
[6]王正国.多发伤的救治[J].中华创伤杂志, 2004, 20(1):1-3.
[7]王正国.王正国创伤外科学[M].上海:上海科学技术出版社, 2002:1-60.
[8]Faulkenberry J G, Schaechter J. Reporting on pediatric unintentional firearm injury:who.s responsible[J]. The journal of trauma and acute care surgery, 2015, 79(3):2-8.
[9]Weiner J, Wiebe D J, Richmond T S, Beam K, Berman AL, Branas CC, et al. Reducing firearm violence:a research agenda[J].Injury prevention:journal of the International Society for Child and Adolescent Injury Prevention 2007, 13(13):80-84.
[10]赵彬,李兵仓.火器伤后遗留的金属异物对人体危害的研究进展[J].解放军医学杂志,2002, 27(12):1123-1124.
[11]Lapostolle F, Borron S W, Gere C, Dallemagne F, Beruben A,Lapandry C, et al. Victims of fall from height. Study of 287 patients and determination of clinical prognostic factors[J]. Annales Franaises Danesthèsie Et De Rèanimation 2004, 23(7):689-693.
[12]周正东,陈训如,卫仕臣. 281例腹部火器伤的诊治[J].中华创伤杂志, 2000,16(6):373-375.
[13]田志强,赵东海,李全岳,等.腹部火器伤131例临床救治分析(附9例尸检资料)[J].中国伤残医学, 2009,17(6):11-13.
[14]P?yry T, Luoto TM, Kataja A, Brander A, Tenovuo O, Iverson GL, et al. Acute assessment of brain injuries in ground-level falls[J]. Journal of Head Trauma Rehabilitation, 2013, 28(2):89-97.
[15]惠纪元. 11937例急性颅脑创伤病人的预后因素分析[D].上海:上海交通大学, 2015:40-70.
[16]赵东华,刘兴炎,葛宝丰,等.负压封闭引流联合灌洗治疗感染软组织火器伤早期疗效的初步实验观察[J].创伤外科杂志,2011,13(4):340-343.
[17]汪月忠,叶志弘,同俏静,等.院内感染控制和预防的精细化管理[J].中华医院管理杂志, 2012, 28(3):234-236.
[18]黄耀添,马平,侯黎升,等.火器性四肢动脉伤[J].中华骨科杂志, 1997(2):110-112.
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