Mann V, Mann S, Szalay G, Hirschburger M, Röhrig R, Dictus C, Wurmb T, Weigand M A, Bernhard M
Klinik für Anaesthesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Deutschland.
Anaesthesist. 2010 Aug;59(8):739-61; quiz 762-3. doi: 10.1007/s00101-010-1771-1.
The treatment of severely injured trauma patients (polytrauma) is one of the outstanding challenges in medical care. Early in the initial course the patient's diagnostics have to be scrupulously reevaluated by an interdisciplinary team (tertiary trauma survey) to reduce deleterious sequelae of missed injuries after the initial assessment. Severely injured patients stay in intensive care for an average of 11 days. During this time the patient's therapy has to ensure a high quality evidence-based intensive care treatment and simultaneously has to be tailored to the current individual injuries. Because of the fact that the damage control strategy is gaining increasing acceptance, the intensive care unit plays a pivotal role in the critical time between emergency and elective surgery. Therefore a close cooperation between physicians of the intensive care unit and all surgical disciplines involved is essential to reach the aim of therapeutic efforts. After survival of emergency treatment patients with severe trauma should be reintegrated into social and occupational life as soon as possible.
严重创伤患者(多发伤)的治疗是医疗护理中一项突出的挑战。在病程早期,必须由跨学科团队对患者诊断进行严格的重新评估(三级创伤检查),以减少初次评估后漏诊损伤的有害后遗症。严重受伤患者在重症监护室平均停留11天。在此期间,患者的治疗必须确保高质量的循证重症监护治疗,同时必须根据当前个体损伤情况进行调整。由于损伤控制策略越来越被接受,重症监护病房在急诊手术和择期手术之间的关键时期起着关键作用。因此,重症监护病房医生与所有相关外科专业之间的密切合作对于实现治疗目标至关重要。严重创伤患者在急诊治疗存活后,应尽快重新融入社会和职业生活。