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从急诊医学到急诊外科

[From casualty medicine to casualty surgery].

作者信息

Ekkernkamp Axel, Probst Jürgen

出版信息

Z Arztl Fortbild Qualitatssich. 2004 Feb;98(1):31-6.

Abstract

For many centuries the treatment of accident casualties -- as proven by evidence from prehistoric times -- has been an essential part of an empirically determined and crafts-oriented surgery. But though the phenomenon of accident and the pathophysiological complex of trauma were faced with the surgical inaccessibility of the human body until in the late 19th century, a kind of casualty medicine supported by multifaceted, scientifically founded observations was trying to repair or alleviate the sequelae of accidents. But only the development of imaging diagnostic procedures made it possible to apply pre-planned target-oriented -- what is modernly called "outcome-oriented" -- surgical procedures. The change in the nature of accidents and their associated health and social consequences demands that the surgeons' attention be specially drawn to this challenge as it presents itself e.g. in the huge field of fracture management, the management of the general sequelae of trauma, emergency rescue and the prevention and control of the secondary effects of trauma (rehabilitation). There has never been any doubt that all this could only be achieved within the discipline of surgery in its entirety, though with the scientifically and practically acquired competence of one its specialties, i.e. casualty surgery, as both a prerequisite and necessary condition.

摘要

几个世纪以来,事故伤亡的治疗——正如史前时期的证据所证明的那样——一直是经验性确定且以手艺为导向的外科手术的重要组成部分。但是,尽管直到19世纪末,事故现象和创伤的病理生理复合体都面临着人体外科手术难以触及的问题,但一种基于多方面科学观察的伤亡医学一直在努力修复或减轻事故的后遗症。但只有成像诊断程序的发展才使得应用预先计划的、以目标为导向的——现代称之为“以结果为导向的”——外科手术成为可能。事故性质及其相关健康和社会后果的变化要求外科医生特别关注这一挑战,例如在骨折管理、创伤一般后遗症的管理、紧急救援以及创伤继发效应的预防和控制(康复)等巨大领域中所呈现的挑战。毫无疑问,所有这一切只有在整个外科学科范围内才能实现,不过需要其一个专业领域,即伤亡外科所具备的科学和实践能力,这既是先决条件也是必要条件。

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