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According to the current meditech conditions in China,we combined the domestic and overseas first aid modes and the problems in severe trauma together and inducted the methods of model study into the procedure of traumatic first aid.The purpose of the study is to establish the procedure of inner-hospital first aid in severe trauma.Through the investigation and practice in Daping Hospital,Third Military Medical University,on the basis principles of organizing first aid with high efficiency,shortening preoperative time and enhancing achievement ratio of remedy,we established the procedure of inner hospital first aid with the typical character of time-control mode.This method can effectively enhance achievement ratio of remedy,decrease the ratio of disability.Moreover,it may promotes the process of entirety,systematization and specialization of inner-hospital first aid in severe trauma.
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Objective Because of high incidence rate of complicated postoperative abdominal infections in abdominal injuries and difficulty in their clinical diagnosis and treatment,this article aimed to investigate the mechanism and the surgical tactics for this kind of complication.Methods Totally 48 abdominal-injured cases of postoperative complicated abdominal infections in our hospital from July 2005 to December 2010 were reviewed.These patients (Male 30,Female 18) aged 16-70 (mean 38) years.There were 20 cases of simple abdominal injuries,and 28 cases of multiple injuries ( ISS 16 - 52,mean 24.42).The complicated postoperative abdominal infections included abdominal incision infections (25cases),intra-abdominal infections( 18 cases) and retroperitoneal infections(5 cases).Forty cases were transferrted from other hospitals to our hospital 2 - 76 days after trauma.16 of which underwent exploratory laparotomy at other hospitals after injury,and 8 cases were directly transferred to our hospital after injury.Results All patients finally had a definite diagnosis by abdominal checking(26 cases),paracentesis(5 cases),ultrasound and CT scan ( 12 cases),and PET/CT scan (5 cases)in our hospital,and were confirmed by cultiure of pathogenic bacteria.The treatment included vacuum sealing drainage (VSD) (25 cases),percutaneous imaging- guided abdominal abscess drainage(13cases) and re-laparotomy ( 10 cases).Successfull treatment was achieved in 46 patients,death in 2 patients.The causes of death consisted of 1 case of severe craniocerebral injury,1 case of MODS.Conclusions Complicated abdominal infections often occurs after the operations of abdominal injuries.attentively abdominal checking,paracentesis,and CT scan repeatedly were proofs to benefit the finally diagnosis.VSD therapy is a simple and effective method for abdominal incision complication,and dynamic CT scan and prompt exploratory laparotomy can improve patients' prognosis.
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<p><b>OBJECTIVE</b>The evaluation of curative effect of CRF by Bushen Jianpi Huoxue Paidu and combination western medicine.</p><p><b>METHOD</b>Gather articles mainly of VIP Information and Wanfang Data of the decade to cure CRF by Bushen Jianpi Huoxue Paidu and combination western medicine with random controlled way, and geostatistical analyse with RevMan4. 2 downloading from Cochrane Collaboration.</p><p><b>RESULT</b>The control group was 3.82 (95% CI, 2.72-5.38), in neurofunction 2 al impairment. The serum creatinine SMD = -0.72 (95% CI, -1.08-(-)0.35). Urea Nitrogen WMD = -3.32 (95% CI, -4.34-(-)2.29), P < 0.05.</p><p><b>CONCLUSION</b>In addition to the routine treatment, the method of Bushen Jianpi Huoxue Paidu can be used by using some Chinese drugs to enhance the clinical effect.</p>
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Humans , Drugs, Chinese Herbal , Therapeutic Uses , Kidney , Kidney Failure, Chronic , Drug Therapy , Randomized Controlled Trials as TopicABSTRACT
Objective To explore the effects and significance of first-aid fast track in the treatment of severe trauma. Methods A retrospective study was done on 60 trauma patients (fast track group)treated by means of first-aid fast track from January 2006 to November 2007 to observe the effect of first-aid fast track. Another 46 trauma patients treated from January 2004 to December 2005 were used as control group. Results There was no statistical difference in aspects of sex, age, injury mechanism, ISS and blood loss in both groups (P ＞0.05). Two patients died in the first track group, with mortality rate of 3% ;while five patients died in the control group, with mortality rate of 11% ( P ＜ 0.05 ). Compared with the control group, there was shorter time in emergency room care, special examination and interval from admission to operating room in fast track group ( P ＜ 0.05 ). Conclusion First-aid fast track can shorten the space and time in treatment of severe trauma, decrease the mortality rate, enhance success rate of treatment and hence guarantee chronergy and integrity of emergency trauma care.
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Objective To explore the role of fibrobronchoscopy in diagnosis and treatment of se- vere chest trauma. Methods A retrospective analysis was done on 114 patients with severe chest trau- ma who were diagnosed and treated by fibrobronchoscope from January 1999 to July 2007. We finished 289 times of fihrohronchoscopies including 181 times through nasal cavity, 32 through tracheal, 52 through oral cavity and 56 through traeheostomy tube. SaO2 and arterial blood gas were monitored continu- ously before and after operation, and respirator support or oxygen was administered simultaneously. Re- suits Definite diagnosis was achieved in all patients, of whom were 102 patients treated with lavement. SaO2 was significantly increased in all patients after bronchial lavement (P <0.01) and Pao2 was signifi- candy ameliorated two hours after bronchial lavement (P < 0.05). Conclusions Fibrobronchoscopy can identify diagnosis of bronchial injury and remove foreign body, secretion, blood and phlegm for pa- tients with severe chest trauma. Meanwhile, fibrohronchoscopy can relieve obstructive atelectasis and ob- structive pneumonia, improve respiratory function and hence increase survival rate.
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At 2:28 p.m. local time on 12 May, 2008, the Wenchuan earthquake struck with a magnitude of 8.0. After the earthquake, 1364 injured persons, including 732 women and 632 men, were admitted to Deyang People's Hospital. The ages of the injured persons ranged from 0.2 years to 102 years (mean, 42.5 years). Of all injured persons, 4.65% aged under 7 years, 13.84% between 7 and 18 years, 39.57% between 19 and 45 years, 24.48% between 46 and 65 years, and 17.46% above 65 years. A total of 1713 injuries were found in all the injured persons, and the predominant injuries were found in limbs, body surface, head and chest. The incidence of the multiple injuries was 23.64%. Eighteen persons with abdominal injuries received operation. Prompt, accurate and systematic evaluation of the injury is necessary in raising the rescue efficiency. Treating the injured persons according to a classification optimizes the usage of the limited medical resources. Early definitive operation is crucial in rescuing the lives of the injured persons, and the treatment should be applied within 24 hours after the earthquake, then the emphasis of the rescue work should shift to helping orthopedic surgeons with operation and debridement.
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Objective To investigate the injury characteristic and the early remedy of the woun-ded in China Wenchuan earthquake. Methods rrhe study involved 1 420 patients from a hospital in City of Deyang during May 12-30,2008. Results There were 1821 injury parts in 1 420 patients.Of all.there were 1 089 patients(76.69%)with single part injury and 331(23.31%)with multiple trau-ma.The injury incidence rate of extremities,body surface and soft tissues was higher than that of the oth-er paris.The incidence rate of single part injury was higher than that of multiple trauma(P＜0.01).The wound flow accounted for 68.80% within 2 days after earthquake,which was more than that in other time (P＜0.01).The patients aged at 19-45 years were more than those at other ages(P＜0.10).Most pa-tients received first remedy 12 hours after earthquake(P＜0.01). Conclusions The speed of remedy is key to disaster rescue.and the gold time for early disaster rescue is within 48 hours after earthquake,when the principle of damage control surgery should be followed.It is necessary,in peace time,to strengthen training of self-care and buddy aid and learning about the knowledge on emergency treatment,as may help save more lives during disaster.
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Salsola collina is widely distributed in droughty and semi-droughty area, which is used as a kind of folk remedy in traditional Chinese medicine for treatment of hypertension. The study is on the chemical constituents of this herb from its aerial parts to obtain its active constituents. Dried and crushed aerial parts of this herb were extracted three times with 95% EtOH at reflux. The ethanol extracts were combined and concentrated under reduced pressure at 70 ℃ to yield residue, which was suspended in water and successively partitioned with light petroleum, chloroform and n-butanol. The chloroform and n-butanol fractions were treated by various chromatographic techniques, such as silica gel, C18 reversed-phase silica gel and macroporous resin column chromatography. Compounds were elucidated by their physicochemical properties and spectroscopic analysis. In the course of our study on searching biological active components from this herb, a new alkaloid together with three known alkaloids were isolated and identified as N-transferuloyl-3-methyldopamine (1), 3-[4-(β-D-glucopyranosyloxy)-3- methoxyphenyl]-N-[2-(4-hydroxyl-3-methoxyphenyl)ethyl]-2-propenamide (2), salsoline A (3), salsoline B (4). Compound 4 is a new compound and named as salsoline B, while compound 2 was obtained in Salsola collina for the first time.
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Medical rescue is the most important key point for deciding disaster prognosis. But there are not systemic and special mode of disaster medical education. This article expounds the concept and features of disaster medicine, and puts forward the idea that the training routes of talents in disaster medicine should be included in undergraduates, vocational and continuing education.
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Objective To explore the methods for early diagnosis and treatment on severe thoracic and abdominal vascular injuries.Methods Eighty one patients were diagnosed as severe thoracic and abdominal vascular injuries and treated from January 2000 to October 2007.Twenty two cases suffered from hemorrhagic shock when admitted to the Emergency Department,from whom amount of inagglutinable blood were drawn out by thoracentesis or peritoneocentesis,and underwent operation immediately;38 cases were diagnosed by spiral CT and angiography(CTA);21 cases were diagnosed by digital substraction angiography.Forty-five patients accepted operation,and 36 cases underwent blood vessel suture and repair.Angiography was performed and blood vessels were blocked by sacculus in 12 cases before operation.Nine cases underwent artificial blood vessel anastomosis,among them 3 cases had to receive damage control for heavy injury,i.e.temporary shunting was made by intubating in the severe damaged blood vessel,the patients were then resuscitated in ICU to improve system condition,and operations were performed in 48 hours.Thirty six patients,including 31 cases of retroperitoneal blood vessel injuries in pelvic cavity,were treated by arterial embolization.Results Of the 81 patients,73 cases were cured(90.1%).Thirty-five cases developed severe complications,including 6 cases of sepsis,8 ARDS and 23 MODS.Eight cases died,of them 6 cases died of multiple organs damaged and hemorrhagic shock within 12 hours after injury,and 2 cases died of sepsis and MODS respectively at 8 and 16 days after injury.Conclusions Examination and diagnosis must be done immediately when the thoracic and abdominal vascular injured,and then the urgent operation of blood vessel repair or anastomosis should be performed.Some abdominal and retroperitoneal vascular injuries may be treated with artery embolization.
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Objective To investigate the changes of intestinal barrier function of patients with multiple injuries,and explore the relationship between the changes and Systemic Inflammatory Response Syndrome(SIRS).Methods Fifty two patients with multiple injury admitted to our hospital from Aug.2007 to May 2008 were divided into mild injury group(n=24,ISS0.05),while obvious increasing existed in moderate and severe groups at 1st day after trauma(P
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Several specialized branches are inclusive in the department of trauma surgery,and the instruction of medical ethics during the practice of trauma surgery surely contributes to raise the integrated diathesis and capability for medical students.Common ethical issues in trauma surgery practice include ethics of operative principles,conflict between trauma sufferers and accident-makers,privacy preservation,decision making,and the principles of clinical pharmaceutical trials,etc.It is believed that advantageous principles and independence principles should be overall carried out during the instructional course of medical ethics education.