Roloff D
Zentrale Rettungs- und Intensivtherapieabteilung, Städtisches Krankenhaus im Friedrichshain.
Anaesthesiol Reanim. 1991;16(1):49-58.
According to the cases reported in the GDR as well as in the FRG, 1-2 persons contract a gas gangrene infection per week. The lethality is alarmingly high. In the GDR more than two thirds of the patients die. Among the numerous factors influencing the prognosis time is a very important one. Through early detection, adequate immediate therapy and subsequent prompt transfer to a treatment centre with facilities for hyperbaric oxygenation, the chances of survival can be improved considerably. Some experiences with the transfer of 275 patients under the tentative diagnosis "gas gangrene" are described, together with the preparation and actual transfer to a specialized centre. For the detection of the disease the clinical symptoms are of greatest importance. The histological findings confirm the diagnosis, bacterioscopy also provides early results. To start treatment early, one cannot wait for the result of the microbiological detection of clostridia which is virtually necessary for exact diagnosis. The initiated treatment (rigorous surgical removal of the gas gangrene focus, antibacterial and intensive therapeutic measures) has to be continued without interruption during transport with a rescue helicopter, aircraft or emergency ambulance. Medical care of the severely ill patient has to be provided throughout transportation. The practical measures are briefly described. The possibility for consultations should be used more frequently.
根据民主德国以及联邦德国所报道的病例，每周有1至2人感染气性坏疽。其致死率高得惊人。在民主德国，超过三分之二的患者死亡。在众多影响预后的因素中，时间是一个非常重要的因素。通过早期发现、充分的即刻治疗以及随后迅速转至具备高压氧治疗设施的治疗中心，存活几率可得到显著提高。本文描述了对275例初步诊断为“气性坏疽”的患者进行转运的一些经验，以及转运至专业中心的准备工作和实际转运过程。对于该病的检测，临床症状最为重要。组织学检查结果可确诊，细菌学检查也能早期得出结果。为尽早开始治疗，不能等待梭状芽孢杆菌微生物检测结果，而这实际上是准确诊断所必需的。已开始的治疗（严格手术切除气性坏疽病灶、抗菌及强化治疗措施）在通过救援直升机、飞机或急救救护车转运期间必须持续不间断。在整个转运过程中都必须对重症患者提供医疗护理。文中简要描述了实际措施。应更频繁地利用会诊的可能性。
