地震中儿童创伤的类型和救治要点

Types of pediatric trauma in earthquake and key points of treatment

摘要:

肢体外伤在儿童地震创伤中最为常见。地震导致的颅脑外伤发生居多，而颅内损伤较少，但颅内损伤是地震创伤致死的首要原因。胸腹挤压伤易致内脏出血等危急情况，也是地震伤患儿主要致死原因之一。挤压综合征和骨筋膜室综合征常常并发急性肾脏功能衰竭。由于地震创伤出现时间集中，现场救援要遵循“救命第一，危重优先”的原则。条件允许时，伤员应及时转运。危重伤员治疗需采用多学科联合序贯方式，重视并发症的防治、康复治疗和心理疏导。

Abstract:

Limb trauma is the most common among pediatric victims in earthquake. Compared with traumatic brain injury, which is frequent in earthquake, intracranial injury is rare, but it is the leading cause of death from trauma in earthquake. Thoracoabdominal crush injury, which often causes such crises as visceral hemorrhage, is also one of the main causes of death among pediatric victims in earthquake. Crush syndrome and osteofascial compartment syndrome are often complicated by acute renal failure. Because trauma is emergent in earthquake, the principle of “life-saving first, critical injury priority” should be complied with during on-site rescue. The injured children must be transferred to the medical center as soon as possible. It is essential to treat the critically injured children by multidisciplinary cooperation, and much attention should be paid to prevention of complications, rehabilitation care, and psychological counseling.