【摘要】 目的:探讨突发灾难后危重多发伤患者在野外条件下的救治方案。方法和结果:患者女性,53岁,因"地震中骨盆砸伤、大量血尿"入院,呼吸困难,全腹压痛,褥疮。便携式B超示腹腔积液,左胸腔积液,膀胱破裂。便携式血气分析仪提示"严重贫血+低氧血症+低钾+酸中毒"。术前行左胸腔穿刺,膀胱穿刺引流。剖腹探查见直肠破裂(穿孔),遂行Harttman手术加膀胱造瘘术和抗感染治疗。术后第18日基本恢复。结论:术者具有精湛的技术和丰富的经验、充分发挥便携式设备的作用、依靠具有地理优势的当地医院、积极抗感染是艰苦环境下救治危重多发伤患者的成功因素。更多还原

【Abstract】 Objective:To study the rescue strategy for patients with severe multiple injuries after sudden disaster under field condition.Methods and results:A 53-year-old female patient was referred to us after hit on the pelvis in the China Wenchuan earthquake.Her symptoms included large volume of hematuria,difficult breath,tenderness of the whole abdomen,and bedsore. Portable B ultrasound revealed effusion of abdomen and left chest cavity,and bladder rupture.Portable blood-gas analyzer indicated severe anemia+hypoxemia+hypokalemia+acidosis.Drainage was done through left chest cavity aspiration and bladder aspiration. Abdominal examination found rectal rupture(perforation),which was managed by Harttman+cystostomy followed by anti-infection treatment.The patient recovered 18 days after operation.Conclusion:The rich experience and skillful surgical management,the full play of portable equipment,the help from the local hospital,together with timely anti-infection management,are the keys to successful rescue of patients with severe multiple injuries under field condition.更多还原