Pasquier P, de Rudnicki S, Donat N, Auroy Y, Merat S
Département d'anesthésie-réanimation, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
Ann Fr Anesth Reanim. 2011 Nov;30(11):819-27. doi: 10.1016/j.annfar.2011.05.018. Epub 2011 Oct 5.
Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of war injuries. Health Force Services organized trauma care system in different levels, with three main objectives: immediate basic medical care in battalion aid station, forward surgery and early aeromedical evacuation. The Joint Theater Trauma Registry (JTTR), a war injury registry, provides medical data, analyzed from the combat theater to the military hospital in United States. This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifically the head region and extremities than the trunk. Hemorrhage is the first cause of death, leading to the concept of avoidable death. Specific databases focused on mechanisms and severity of injuries, diagnostic and treatment difficulties, outcomes can guide research programs to improve war injuries prevention and treatment.
自2003年3月以来，伊拉克的“伊拉克自由行动”（OIF）和阿富汗的“持久自由行动”（OEF）军事行动已造成许多人在行动中伤亡。本文旨在突出在这些非传统和不对称冲突中遇到的战斗伤亡的具体流行病学情况。个人防护装备，如凯夫拉头盔和防弹衣，已证明它们在改变战争创伤特征方面的有效性。卫生部队服务部门在不同层面组织了创伤护理系统，有三个主要目标：在营救护站提供即时基本医疗护理、前沿手术和早期空中医疗后送。联合战区创伤登记处（JTTR）是一个战争创伤登记处，提供从战场到美国军事医院分析的医疗数据。该分析得出结论，在现代冲突中，大多数损伤是由爆炸装置造成的；损伤更严重，有趣的是，与躯干相比，头部和四肢的损伤更为具体。出血是首要死因，由此引出了可避免死亡的概念。专注于损伤机制和严重程度、诊断和治疗困难以及结果的特定数据库可以指导研究项目，以改善战争创伤的预防和治疗。
