Upadhyaya Gaurav K, Iyengar Karthikeyan P, Jain Vijay Kumar, Garg Rakesh
Department of Orthopaedics, All India Institute of Medical Sciences, Raebareli, UP, 229405, India.
Southport and Ormskirk NHS Trust Southport, UK.
J Clin Orthop Trauma. 2021 Jan;12(1):58-65. doi: 10.1016/j.jcot.2020.10.021. Epub 2020 Oct 13.
Major trauma is one of the leading causes of morbidity and mortality in young adults. The impact of disability on the quality of life and functionality in this younger population is worrisome. This remains a major public health concern across the globe. Immediate and early deaths account for nearly 80% of trauma deaths occurring within the first few hours of injury to the first few days, usually because of traumatic brain injury or major exsanguination and subsequently due to shock or hypoxia. Worldwide adoption of comprehensive trauma systems and evolving models of trauma care including prehospital interventions have led improvements in trauma and critical care over the last few decades. Resuscitation and damage control orthopaedics are two key pillars in the management of polytrauma patient. Trauma-related coagulopathy can be an emerging complication during resuscitation of such patients which should be recognized early so appropriate corrective measures can be undertaken. We describe the evolving models of care in the management of polytrauma and trauma associated coagulopathy.
严重创伤是年轻成年人发病和死亡的主要原因之一。残疾对这一年轻人群生活质量和功能的影响令人担忧。这仍是全球主要的公共卫生问题。伤后数小时至数天内，近80%的创伤死亡为即刻和早期死亡，通常是由于创伤性脑损伤或严重失血，随后是由于休克或缺氧。在过去几十年里，全球采用综合创伤系统以及不断发展的创伤护理模式（包括院前干预）已使创伤和重症护理得到改善。复苏和损伤控制骨科是多发伤患者管理的两大关键支柱。创伤相关凝血病可能是此类患者复苏过程中出现的并发症，应尽早识别以便采取适当的纠正措施。我们描述了多发伤和创伤相关凝血病管理中不断发展的护理模式。
