Champion Howard R, Bellamy Ronald F, Roberts Colonel P, Leppaniemi Ari
Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
J Trauma. 2003 May;54(5 Suppl):S13-9. doi: 10.1097/01.TA.0000057151.02906.27.
Traumatic combat injuries differ from those encountered in the civilian setting in terms of epidemiology, mechanism of wounding, pathophysiologic trajectory after injury, and outcome. Except for a few notable exceptions, data sources for combat injuries have historically been inadequate. Although the pathophysiologic process of dying is the same (i.e., dominated by exsanguination and central nervous system injury) in both the civilian and military arenas, combat trauma has unique considerations with regard to acute resuscitation, including (1) the high energy and high lethality of wounding agents; (2) multiple causes of wounding; (3) preponderance of penetrating injury; (4) persistence of threat in tactical settings; (5) austere, resource-constrained environment; and (5) delayed access to definitive care. Recognition of these differences can help bring focus to resuscitation research for combat settings and can serve to foster greater civilian-military collaboration in both basic and transitional research.
创伤性战斗损伤在流行病学、致伤机制、伤后病理生理过程及预后方面与平民环境中所遇到的损伤有所不同。除了少数显著的例外情况，历史上战斗损伤的数据来源一直不足。尽管在平民和军事领域，死亡的病理生理过程是相同的（即主要由失血和中枢神经系统损伤主导），但战斗创伤在急性复苏方面有独特的考量因素，包括：（1）致伤因素的高能量和高致死性；（2）多种致伤原因；（3）穿透伤占优势；（4）战术环境中威胁持续存在；（5）严峻、资源受限的环境；以及（6）获得确定性治疗的延迟。认识到这些差异有助于将重点放在战斗环境的复苏研究上，并有助于在基础研究和转化研究中促进更大程度的军民合作。
