地震灾害伤员的挤压伤早期处理
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摘要
[目的]地震危害大,近年发生频繁。地震灾害伤员中以肌肉骨骼伤员最多、最常见。地震引起大量成片房屋倒塌、山体垮塌等,导致无数的灾害者死亡,而即使幸存者,由于被废墟压迫而长时间被困,导致了地震伤员中最常见的挤压伤。这些伤员很容易发生筋膜间室综合征和挤压综合征,救治不及时、处理不正确,很容易导致病人截肢、甚至死亡。本文结合近年来地震文献对这类损伤的处理,对筋膜间室综合征和挤压综合征作一阐述,以提高地震灾害伤员处理的准确性和有效性。
引文
[1]Better OS.History of the crush syndrome:from the earthquakes of Messina Sicily1909to Spitak,Armenia1988[J].Am J Nephrol,1997,17:392-394.
[2]Better OS,Stein JH.Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis[J].N Engl J Med,1990,322:825-829.
[3]Sheng ZY.Medical support in the Tangshan earthquake:a review of the management of mass casualties and certain major injuries[J].J Trauma,1987,27:l130-1135.
[4]da J,Tanaka H.Yozhioka T,et al.Analysis of372patients with crush syndrome caused by the Hanshin-Awaji earthquake[J].J Trauma,1997,42:470-475.
[5]Bywaters EGL.50years on:the crush syndrome[J].Br MED J,1990,301:1412-1415.
[6]Frankenthal L.Ueber Verschuettungen(in German)[J].Virchows Archives,1916,22:332-345.
[7]Bywaters EGL,Beal D.Crush injuries with impairment of renal func-tion[J].Br MED J,1941,1:427-432.
[8]Bywaters EGL,Delory GE,Rimington C,et al.Myohaemoglobin in air raid casualties with crushing injury[J].Biochem J,1941,35:1164-1168.
[9]Bywaters EGL,Popjak G.Experimental crushing injury[J].Surg Gynecol Obstet,1942,75:612-627.
[10]Bywaters EGL.Ischaemic muscle necrosis[J].JAMA,1944,124:1103-1109.
[11]Trueta J,Barlay AE,Daniel PM,et al.Studies of the renal circula-tion[M].Oxford:Blackwell Scientific Publications,1947,67-126.
[12]Reid MB.Reactive oxygen and nitric oxide in skeletal muscle[J].News Phys Sci,1996,11:114-119.
[13]Moncada S.Higgs A.Molecular mechanisms and therapeutic strategies related to nitricoxide[J].Fed Am Soc Exp Biol J,1995,9:1319-1330.
[14]Better OS,Rubinstein I,Winaver JM,et al.Mannitol therapy revisi-ted(1940-1997)[J].Kidney Int,1997,51:886-894.
[15]Skyhar MJ,Hargens AR,Strauss MB,et al.Hyperbaric oxygen re-duces edema and necrosis of skeletal muscle in compartment syn-dromes associated with haemorrhagic hypotension[J].J Bone Joint Surg(AM),1986,68:1218-1224.
[16]Strauss MB,Hart GB.Hyperbaric oxygen and the skeletal muscle compartment syndrome[J].Contemporary Orthopaedics,1989,18:167-174.
[17]Michaclson M.Crush injury and crush syndrome[J].World J Surg,1992,16:899-903.
[18]Stein H,Hoerer D,Weisz I,et al.Musculoskeletal injuries in earth-quake victims:an update on orthopedic management[J].Orthope-dics,2000,10:1085-1087.
[19]Better OS,Zinman C,Reis D,et al.Hypertonic mannitol amelio-rates intracompartment tamponade in model compartment syndrome in the dog[J].Nephron,1991,58:344-346.
[20]Sever SM,Erek E,Vanholder R,et al.Clinical findings in the renal victims ofacatastrophic disaster.The Marmara earthquake[J].Neph-rol Dial Transplant,2002,17:1942-1949.
[21]Gunal AL,Celiker H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of cata-strophic earthquakes[J].J Am Soc Nephrol,2004,15:1862-1867.
[22]Tetsuya M,Toshiharu Y,Hiroshi T,et al.Long term physical out-come of patients who suffered crush syndrome after the1995hanshin-Awaji earthquake:prognostic indicators in retrospect[J].J Trau-ma,2002,52:33-39.
[23]Huang KC,Lee TS,Lin YM,et al.Clinical features and outcome of crush syndrome caused by the chi-chi earthquake[J].J Formos Med Assoc,2002,101:249-256.
[24]Nadjafi I,Ater MR,Broumand B,et al.Suggested guidelines for treatment of acute renal failure in earthquake victims[J].Ren Fail,1997,19:655-664.
[25]Reis ND,Better OS.Mechanical muscle-crush injury and acute mus-cle-crush compartment syndrome:with special reference to earth-quake casualties[J].J Bone Joint Surg Br,2005,87(4):450-453.
[26]Ritenour AE,Dorlac WC,Fang R,et al.Complications after fas-ciotomy revision and delayed compartment release in combat patients[J].J Trauma,2008,64:153-161;161-162.
[2]Better OS,Stein JH.Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis[J].N Engl J Med,1990,322:825-829.
[3]Sheng ZY.Medical support in the Tangshan earthquake:a review of the management of mass casualties and certain major injuries[J].J Trauma,1987,27:l130-1135.
[4]da J,Tanaka H.Yozhioka T,et al.Analysis of372patients with crush syndrome caused by the Hanshin-Awaji earthquake[J].J Trauma,1997,42:470-475.
[5]Bywaters EGL.50years on:the crush syndrome[J].Br MED J,1990,301:1412-1415.
[6]Frankenthal L.Ueber Verschuettungen(in German)[J].Virchows Archives,1916,22:332-345.
[7]Bywaters EGL,Beal D.Crush injuries with impairment of renal func-tion[J].Br MED J,1941,1:427-432.
[8]Bywaters EGL,Delory GE,Rimington C,et al.Myohaemoglobin in air raid casualties with crushing injury[J].Biochem J,1941,35:1164-1168.
[9]Bywaters EGL,Popjak G.Experimental crushing injury[J].Surg Gynecol Obstet,1942,75:612-627.
[10]Bywaters EGL.Ischaemic muscle necrosis[J].JAMA,1944,124:1103-1109.
[11]Trueta J,Barlay AE,Daniel PM,et al.Studies of the renal circula-tion[M].Oxford:Blackwell Scientific Publications,1947,67-126.
[12]Reid MB.Reactive oxygen and nitric oxide in skeletal muscle[J].News Phys Sci,1996,11:114-119.
[13]Moncada S.Higgs A.Molecular mechanisms and therapeutic strategies related to nitricoxide[J].Fed Am Soc Exp Biol J,1995,9:1319-1330.
[14]Better OS,Rubinstein I,Winaver JM,et al.Mannitol therapy revisi-ted(1940-1997)[J].Kidney Int,1997,51:886-894.
[15]Skyhar MJ,Hargens AR,Strauss MB,et al.Hyperbaric oxygen re-duces edema and necrosis of skeletal muscle in compartment syn-dromes associated with haemorrhagic hypotension[J].J Bone Joint Surg(AM),1986,68:1218-1224.
[16]Strauss MB,Hart GB.Hyperbaric oxygen and the skeletal muscle compartment syndrome[J].Contemporary Orthopaedics,1989,18:167-174.
[17]Michaclson M.Crush injury and crush syndrome[J].World J Surg,1992,16:899-903.
[18]Stein H,Hoerer D,Weisz I,et al.Musculoskeletal injuries in earth-quake victims:an update on orthopedic management[J].Orthope-dics,2000,10:1085-1087.
[19]Better OS,Zinman C,Reis D,et al.Hypertonic mannitol amelio-rates intracompartment tamponade in model compartment syndrome in the dog[J].Nephron,1991,58:344-346.
[20]Sever SM,Erek E,Vanholder R,et al.Clinical findings in the renal victims ofacatastrophic disaster.The Marmara earthquake[J].Neph-rol Dial Transplant,2002,17:1942-1949.
[21]Gunal AL,Celiker H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of cata-strophic earthquakes[J].J Am Soc Nephrol,2004,15:1862-1867.
[22]Tetsuya M,Toshiharu Y,Hiroshi T,et al.Long term physical out-come of patients who suffered crush syndrome after the1995hanshin-Awaji earthquake:prognostic indicators in retrospect[J].J Trau-ma,2002,52:33-39.
[23]Huang KC,Lee TS,Lin YM,et al.Clinical features and outcome of crush syndrome caused by the chi-chi earthquake[J].J Formos Med Assoc,2002,101:249-256.
[24]Nadjafi I,Ater MR,Broumand B,et al.Suggested guidelines for treatment of acute renal failure in earthquake victims[J].Ren Fail,1997,19:655-664.
[25]Reis ND,Better OS.Mechanical muscle-crush injury and acute mus-cle-crush compartment syndrome:with special reference to earth-quake casualties[J].J Bone Joint Surg Br,2005,87(4):450-453.
[26]Ritenour AE,Dorlac WC,Fang R,et al.Complications after fas-ciotomy revision and delayed compartment release in combat patients[J].J Trauma,2008,64:153-161;161-162.
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