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[军事冲突中重伤人员的护理]

[Care for Seriously Injured People in Military Conflicts].

作者信息

Franke Axel, Sahm Joachim, Bieler Dan, Achatz Gerhard

机构信息

Department of Trauma, Orthopedic and Reconstructive Surgery and Sportsmedicine, German Armed Forces Hospital Ulm, Ulm, Deutschland.

Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital Koblenz, Koblenz, Deutschland.

出版信息

Zentralbl Chir. 2024 Aug;149(4):350-358. doi: 10.1055/a-2348-1043. Epub 2024 Aug 7.

Abstract

The current war in Ukraine has drawn public attention to the treatment of war injuries. Follow-up treatment in Germany is portrayed the clover leaf of the TraumaNetzwerke DGU, is largely based on the demands of the Federal Ministries for Defence and Health and is intended to enhance resilience in war.The present article presents the special features of the care of severely injured patients during hostilities and should provide insights into the expected results of treatment and the actual procedures. We emphasise the unpredictability of the care of the severely injured during hostilities.On the basis of a search of the literature for the deployment of the German Army in Afghanistan and for the current war in Ukraine, we present the challenges and the typical patterns of injuries. We discuss the factors that can influence the procedures and the quality of the results during hostilities and how these may differ from civil polytrauma care in Germany - which is well established and standardised.Even during deployment of the Federal Army or (as planned) NATO, care of the severely injured is under standardised conditions, as based on the algorithmic ATLS care and which is concentrated on bleeding control. The corresponding equipment and personnel are well established, well prepared and well trained.However, there may be special local conditions or special deployments that make it inevitable that emergency medical care will be more delayed than in the civil system in Germany and can only take place after protracted transport. The objective is always that soldiers in combat should be able to receive medical care that is equivalent to that received by all accident victims in Germany, whatever the time and site of the accident.

摘要

当前的俄乌战争已引起公众对战争创伤治疗的关注。在德国,后续治疗以创伤网络DGU的三叶草模式为蓝本,很大程度上基于联邦国防部和卫生部的要求,旨在增强战争中的恢复能力。本文介绍了敌对行动期间重伤患者护理的特点,并应能让人深入了解预期的治疗结果和实际程序。我们强调敌对行动期间重伤患者护理的不可预测性。基于对德国军队在阿富汗部署以及当前俄乌战争相关文献的检索,我们呈现了挑战和典型的损伤模式。我们讨论了在敌对行动期间可能影响治疗程序和结果质量的因素,以及这些因素与德国已成熟且标准化的民事多发伤护理有何不同。即使在联邦军队部署期间或(按计划)北约行动期间,重伤患者的护理也是在标准化条件下进行的,这基于算法化的高级创伤生命支持护理,且侧重于出血控制。相应的设备和人员配备完善、准备充分且训练有素。然而,可能存在特殊的当地情况或特殊部署,使得紧急医疗护理不可避免地比德国民事系统更延迟,且只能在长时间转运后进行。目标始终是让作战中的士兵无论在何时何地发生事故,都能得到与德国所有事故受害者同等的医疗护理。

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