建立爆炸复合式胸腹伤战救损伤控制外科训练平台。
Establishment of a combat damage control surgery training platform for explosive combined thoraco-abdominal injuries.
机构信息
State Key Laboratory of Trauma, Burn and Combined Injury, Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University, Chongqing, 400038, China.
Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400038, China.
出版信息
Chin J Traumatol. 2022 Jul;25(4):193-200. doi: 10.1016/j.cjtee.2022.03.003. Epub 2022 Mar 11.
PURPOSE
It is challenging to prepare military surgeons with the skills of combat damage control surgery (CDCS). The current study aimed to establish a damage control surgery (DCS) training platform for explosive combined thoraco-abdominal injuries.
METHODS
The training platform established in this study consisted of 3 main components: (1) A 50 m × 50 m square yard was constructed as the explosion site. Safety was assessed through cameras. (2) Sixteen pigs were injured by an explosion of trinitrotoluene attached with steel balls and were randomly divided into the DCS group (accepted DCS) and the control group (have not accepted DCS). The mortality rate was observed. (3) The literature was reviewed to identify the key factors for assessing CDCS, and testing standards for CDCS were then established. Expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Then, a 5-day training course with incorporated tests was used to test the efficacy of the established platform. In total, 30 teams attended the first training course. The scores that the trainees received before and after the training were compared. SPSS 11.0 was employed to analyze the results.
RESULTS
The high-speed video playback confirmed the safety of the explosion site as no explosion fragments projected beyond the wall. No pig died within 24 h when DCS was performed, while 7 pigs died in the control group. After a literature review, assessment criteria for CDCS were established that had a total score of 100 points and had 4 major parts: leadership and team cooperation, resuscitation, surgical procedure, and final outcome. Expert questionnaire results showed that the scientific score was 8.6 ± 1.25, and the feasibility score was 8.74 ± 1.19. When compared with the basic level, the trainees' score improved significantly after training.
CONCLUSION
The platform established in this study was useful for CDCS training.
目的
培养具有战伤控制性手术（CDCS）技能的军医具有挑战性。本研究旨在建立一种用于爆炸合并胸腹伤的损伤控制性手术（DCS）培训平台。
方法
本研究建立的培训平台由 3 个主要部分组成：（1）构建了一个 50m×50m 的方形院子作为爆炸现场。通过摄像头评估安全性。（2）将十六头猪用附有钢球的三硝基甲苯爆炸致伤，并随机分为 DCS 组（接受 DCS）和对照组（未接受 DCS）。观察死亡率。（3）复习文献确定 CDCS 的关键评估因素，建立 CDCS 的测试标准。采用专家问卷评估测试标准的科学性和可行性。然后，采用为期 5 天的培训课程和综合测试来检验建立的平台的效果。共有 30 个团队参加了第一次培训课程。比较了培训前后学员的得分。采用 SPSS 11.0 分析结果。
结果
高速视频回放证实爆炸现场是安全的，没有爆炸碎片超出墙壁。进行 DCS 时，没有猪在 24 小时内死亡，而对照组有 7 头猪死亡。文献复习后，建立了 CDCS 的评估标准，总分为 100 分，有 4 个主要部分：领导力和团队合作、复苏、手术程序和最终结果。专家问卷结果显示，科学评分 8.6±1.25，可行性评分 8.74±1.19。与基础水平相比，培训后学员的分数明显提高。
结论
本研究建立的平台可用于 CDCS 培训。
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