美军战术战伤救治指南透析与借鉴
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摘要
新军事变革使卫勤保障面临多种挑战,要求战伤救治理念不断更新发展。战术战伤救治(TCCC)是近年来国际军事医学领域研究关注的热点,也是我军卫勤实战化训练研究的焦点。由于TCCC指南在战场上得到了充分的实战检验,使美军战斗伤员死亡率降至历史最低水平,因此成为美军以及部分北约国家军队一线战伤急救的新标准。该文梳理了美军TCCC指南的发展历程,并概括总结了在战术环境中实施战伤救治需要把握的基本原则,旨在为促进我军战伤救治理论发展与体系建设提供借鉴。
The new military revolution has exposed health support to many challenges and requires the continuous improvement of war-wound treatment technology. The tactical combat casualty care(TCCC)is not only a hot spot in the field of military medicine,but also the focus of the actual combat medical training of PLA. As the death rate of the US military combat casualties has fallen to the lowest level in history,the TCCC has become the new standard for prehospital trauma care of the US military and some NATO countries.This article summarizes the development process of the US TCCC guidelines,and summarizes the basic principles that need to be grasped in the implementation of war injury treatment in the tactical environment,aiming to provide reference for improving the first-aid capabilities on the battle field.
The new military revolution has exposed health support to many challenges and requires the continuous improvement of war-wound treatment technology. The tactical combat casualty care(TCCC)is not only a hot spot in the field of military medicine,but also the focus of the actual combat medical training of PLA. As the death rate of the US military combat casualties has fallen to the lowest level in history,the TCCC has become the new standard for prehospital trauma care of the US military and some NATO countries.This article summarizes the development process of the US TCCC guidelines,and summarizes the basic principles that need to be grasped in the implementation of war injury treatment in the tactical environment,aiming to provide reference for improving the first-aid capabilities on the battle field.
引文
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[7] U.S. Department of Defense. DoD Instruction 1322.24,Medical Readiness Training[EB/OL].(2018-03-16)[2018-12-25].http://www.esd.whs.mil/DD.
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[10] Eastridge BJ,Mabry RL,Seguin P,et al. Death on the battle field(2001-2011):implications for the future of combat casualty care[J]. J Trauma Acute Care Surg,2012,73(6):S431-S436.
[11]黎檀实,潘菲,宋海楠.战术战伤救治指南的研究进展[J].中国急救复苏与灾害医学杂志,2015,10(1):5-7.
[12] Kragh JF,Dubick MA. Bleeding control with limb tourniquet use in the wilderness setting:review of science[J]. Wilderness Environ Med,2017,28(Suppl):S25-S32.
[13]陈文亮.现代卫勤前沿理论[M].北京:军事医学科学出版社,2006.
[14] Kotwal RS,Howard TH,Orman JA,et al. The effect of a golden hour policy on the morbidity and mortality of combat casual-ties[J]. JAMA Surg,2016,151(1):15-24.
[15]宗兆文,张连阳,秦昊,等.我军战伤伤情评估和诊断方法的专家共识[J].解放军医学杂志,2018,43(3):181-183.
[2] Butler FK Jr. Tactical combat casualty care:beginnings[J]. Wilderness Environ Med,2017,28(Suppl):S18-S24.
[3]黎檀实.战术战伤救治理论与实践研究[J].中国急救复苏与灾害医学杂志,2015,10(1):1-3.
[4] Giebner SD. The transition to the Committee on Tactical Combat Casualty Care[J]. Wilderness Environ Med,2017,28(2S):S18-S24.
[5]李丽娟,邢克飞,刁天喜.美军新版《战术战伤救治指南》简介[J].解放军医院管理杂志,2018,25(2):194-196.
[6] Holcomb JB,Stansbury LG,Champion HR.et al. Understanding combat casualty care statistics[J]. J Trauma,2006,60(2):397-401.
[7] U.S. Department of Defense. DoD Instruction 1322.24,Medical Readiness Training[EB/OL].(2018-03-16)[2018-12-25].http://www.esd.whs.mil/DD.
[8] Champion HR,Bellamy RF. A profile of combat injury[J].J Trauma,2003,54(5):S13-S19.
[9] Kotwal RS,Montgomery HR,Kotwal BM,et al. Eliminating pre-ventable death on the battle field[J]. Arch Surg,2011,146(12):1350-1358.
[10] Eastridge BJ,Mabry RL,Seguin P,et al. Death on the battle field(2001-2011):implications for the future of combat casualty care[J]. J Trauma Acute Care Surg,2012,73(6):S431-S436.
[11]黎檀实,潘菲,宋海楠.战术战伤救治指南的研究进展[J].中国急救复苏与灾害医学杂志,2015,10(1):5-7.
[12] Kragh JF,Dubick MA. Bleeding control with limb tourniquet use in the wilderness setting:review of science[J]. Wilderness Environ Med,2017,28(Suppl):S25-S32.
[13]陈文亮.现代卫勤前沿理论[M].北京:军事医学科学出版社,2006.
[14] Kotwal RS,Howard TH,Orman JA,et al. The effect of a golden hour policy on the morbidity and mortality of combat casual-ties[J]. JAMA Surg,2016,151(1):15-24.
[15]宗兆文,张连阳,秦昊,等.我军战伤伤情评估和诊断方法的专家共识[J].解放军医学杂志,2018,43(3):181-183.