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中国专家关于现代战争骨盆骨折分级治疗的共识。

Chinese expert consensus on echelons treatment of pelvic fractures in modern war.

机构信息

State Key Laboratory of Trauma, Burn and Combined Injury, Department of War Wound Rescue Skills Training, Base of Army Health Service Training, Army Medical University, ChongQing, 400038, China.

First Department, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.

出版信息

Mil Med Res. 2018 Jun 30;5(1):21. doi: 10.1186/s40779-018-0168-3.

Abstract

The characteristics and treatment of pelvic fractures vary between general conditions and modern war. An expert consensus has been reached based on pelvic injury epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. According to this consensus, first aid, emergency treatment and early treatment of pelvic fractures are introduced in three separate levels. In Level I facilities, simple triage and rapid treatment following the principles of advanced trauma life support are recommended to evaluate combat casualties during the first-aid stage. Re-evaluation, further immobilization and fixation, and hemostasis are recommended at Level II facilities. At Level III facilities, the main components of damage control surgery are recommended, including comprehensive hemostasis, a proper resuscitation strategy, the treatment of concurrent visceral and blood vessel damage, and battlefield intensive care. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

摘要

骨盆骨折的特点和治疗方法因一般情况和现代战争而异。根据骨盆损伤流行病学以及战场治疗理念,并结合现代战争中现有军事医疗水平,专家们达成了共识。根据这一共识,将骨盆骨折的急救、紧急治疗和早期治疗分为三个不同层次进行介绍。在一级医疗机构中,建议根据高级创伤生命支持原则进行简单的分诊和快速治疗,以在急救阶段评估战斗伤员。在二级医疗机构中,建议重新评估、进一步固定和止血。在三级医疗机构中,建议采用损伤控制性手术的主要内容,包括全面止血、适当的复苏策略、处理合并的内脏和血管损伤以及战场重症监护。本专家共识采用证据评估和推荐分级标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f75/6029371/820646756149/40779_2018_168_Fig1_HTML.jpg

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