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应对“死亡三角”:严重多发伤救治的多学科方法

Navigating the 'Triangle of Death': A Multidisciplinary Approach in Severe Multi-Trauma Management.

作者信息

Zhang Yushan, Jian Fuxia, Wang Liang, Chen Hao, Wu Zhengbin, Zhong Shili

机构信息

Department of Intensive Care Medicine, Army Medical Center of PLA, Yuzhong District, Chongqing, China.

Dermatology, Army Medical Center of PLA, Yuzhong District, Chongqing, China.

出版信息

Clin Med Insights Case Rep. 2024 Aug 13;17:11795476241271544. doi: 10.1177/11795476241271544. eCollection 2024.

Abstract

This case report details the challenging management of a 45-year-old male construction worker who suffered severe multiple injuries after a fall and subsequent collision with cement mixers. The patient presented with extensive injuries, including amputation, fractures and internal bleeding, leading to a state known as the 'triangle of death'. Despite the initial grim prognosis, evidenced by an ISS score of 28 and a mortality risk coefficient of 89.56%, the patient was successfully resuscitated and managed through a multidisciplinary approach. This included damage control resuscitation, emergency vascular interventions and targeted temperature management for brain protection. The patient's recovery highlights the effectiveness of comprehensive trauma management and the critical role of coordinated care in severe multi-trauma cases.

摘要

本病例报告详细介绍了一名45岁男性建筑工人的挑战性治疗过程。该工人在摔倒并随后与水泥搅拌机相撞后受了多处重伤。患者全身多处受伤,包括截肢、骨折和内出血,导致出现了所谓的“死亡三角”状态。尽管最初预后严峻,损伤严重度评分(ISS)为28分,死亡风险系数为89.56%,但通过多学科方法,患者成功复苏并得到治疗。这包括损伤控制复苏、紧急血管介入以及用于脑保护的目标温度管理。患者的康复突出了综合创伤管理的有效性以及多学科协作护理在严重多发伤病例中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9dd/11325324/916c12b71461/10.1177_11795476241271544-fig1.jpg

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