严重胸部创伤的急救体会

目的总结探讨严重胸部创伤救治的经验与体会。方法回顾性分析本院2007—2010年抢救严重胸部创伤患者57例的临床资料。结果抢救成功52例,死亡5例。结论严重胸部创伤病情复杂而危急,应尽快明确诊断,迅速、果断及正确处理是提高抢救成功率的关键。     

重型颅脑损伤合并严重胸损伤的临床救治

目的 探讨重型颅脑损伤合并严重胸损伤的诊断和治疗.方法 对32例重型颅脑损伤合并严重胸损伤的临床资料进行分析.结果 GOS预后评分:恢复良好14例,中残9例,重残3例,植物生存2例,死亡4例.结论 重型颅脑损伤合并严重胸损伤其伤情复杂而严重,伤残率和病死率较高.全面详细的检查、正确的诊断和及时有效的治疗和处理,弄清颅脑损伤和胸部损伤的关系,积极防治成人呼吸窘迫综合征(ARDS)及肺部感染等并发症,是提高抢救成功率的关键.     

重度胸部损伤182例救治体会

目的 探讨重度胸部损伤的诊断及救治方法,提高重度胸部损伤的抢救成功率.方法 对2000～2009年收治的182例重度胸部损伤的临床资料进行回顾性分析总结.结果　治愈160例,死亡22例,病死率为12.1%,死亡原因主要为合并其他重要器官损伤、术后急性呼吸窘迫综合征(14例)和多器官功能衰竭(8例).结论 重度胸部损伤(尤其是合并重度颅脑损伤、肝脾破裂大出血)临床特点为伤势严重、呼吸困难、循环紊乱、休克、低氧血症、意识障碍、病死率高.救治原则是尽快明确诊断,尽快恢复呼吸循环稳定,及早手术治疗,优先处理致命伤,积极防治并发症.     

心脏穿透性损伤的急诊救治

目的 总结心脏穿透性损伤的急诊救治经验.方法 对47例心脏穿透性损伤患者的临床资料作回顾性分析.结果 急诊手术42例,均抢救成功.3例入院时已死亡,2例在急诊科抢救无效死亡.结论 早期诊断、及时手术是心脏穿透性损伤抢救成功的关键.对本病的诊断,胸部CT比其他检查更具优越性.简化院内抢救流程,缩短就诊至手术的时间,将能提高抢救成功率.     

手术治疗外伤性肝破裂23例

目的:总结外伤性肝破裂的手术治疗经验.方法:收集我院2006-2011年手术治疗的23例外伤性肝破裂患者临床资料,进行回顾性分析.结果:23例外伤性肝破裂患者手术治愈20例,死亡3例.死亡病例中,1例死于多脏器联合损伤,肝、脾、肾均破裂,骨盆粉碎性骨折;1例死于胸部严重创伤急性呼吸窘迫综合征;1例死亡于Ⅵ级肝破裂术后继发多器官功能衰竭(multiple organ failure,MOF).肝破裂严重或合并MOF患者死亡率高.早期准确的诊断和正确及时的手术治疗是抢救患者生命、提高治愈率、减少死亡率的关键.结论:对于需手术治疗的患者用最简单的术式,在最短的时间内完成手术能提高存活率,减少并发症.     

严重多发伤354例急救分析

目的探讨严重多发伤的急救方法和措施,以提高其抢救成功率。方法对院前急救组213例和非院前急救组141例严重多发伤患者的抢救措施和效果进行分析及比较。观察两组患者从受创伤至送达急诊室的时间（T1）、病死率、患者到达急诊室至死亡时间（T2）。结果两组患者的T1、病死率、T2间差异有统计学意义（P〈0．05）。结论院前急救能降低严重多发伤病死率。加强创伤“黄金时间”的抢救,是提高严重多发伤抢救成功率的关键。     

心脏损伤98例的外科治疗

目的总结心脏损伤的救治经验,旨在提高其早期诊断和抢救的水平。方法回顾性分析1999年7月至2011年12月救治的98例心脏损伤患者的资料,全部患者心脏损伤的诊断均由手术证实。根据患者的外伤史、体表伤口、临床征象等进行早期诊断,部分患者结合胸部X线、测定中心静脉压和心包穿刺等进行诊断。结果全组死亡11例,病死率11.22%,成活87例,存活率88.78%。结论加强院前救治及转运,缩短患者受伤到手术时间,进行快速和正确的病种分类(休克和心脏压塞),能提高心脏损伤抢救的成功率。     

基层医院多发性创伤的急诊救治体会

目的探讨基层医院多发性创伤的临床特点及救治措施,提高急诊救治多发伤的成功率。方法回顾性分析2010-02~2014-09宾阳县人民医院收治的66例多发性创伤患者的临床资料。结果本组抢救成功56例,成功率为84.85%,死亡10例,病死率为15.15%。3种不同ISS评分者病死率比较差异有统计学意义(P0.01)。合并有颅脑损伤者病死率为23.33%,高于未合并颅脑损伤者的8.33%,但比较差异无统计学意义(P0.05)。结论多发性创伤致病因素多种多样,创伤程度ISS评分对多发性创伤患者预后评估具有一定指导价值,临床上对合并颅脑损伤的多发性创伤患者应加以重视。     

急诊多发性创伤84例院外急救体会

目的 总结分析急诊多发性创伤的院外急救体会.方法 回顾性分析宽城县中医院救治的84例多发性创伤患者院外急救资料.结果 院外急救84例多发性创伤患者中,死亡5例,创伤院外急救成功率为91.13%(79/84).结论 急诊多发性创伤患者,现场抢救是创伤急救的开始,做好现场的抢救和转运途中的救护工作,是提高抢救成功率的重要环节.     

严重复合伤的早期诊治分析

回顾分析1998～2008年收治的236例严重复合伤患者的临床资料.认为严重复合伤的颅脑伤是主要死亡原因,其次为大出血.抓紧创伤急救的黄金时间是抢救成功的关键,提高早期诊断的准确性,优先处理危及生命的损伤是提高严重复合伤救治成功的重要因素.     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

Inhibition of intimal thickening of the carotid artery of rabbits and of outgrowth of explants of aorta by probucol.

The effect of administration of probucol in preventing intimal thickening of rabbit carotid artery after balloon catheter injury and the mechanism of action of the drug were studied. Groups of 6 male New Zealand-White rabbits were given normal diet (Group I), high cholesterol diet (Group II) or high cholesterol diet plus probucol (Group III) for 4 weeks. Balloon catheter injury was made in week 2 and animals were killed in week 4. No significant differences in the total cholesterol levels in Groups II and III were found in week 4. The medians of areas of the intimal layer in cross-sections of the carotid arteries of Groups I, II and III were 0.237, 0.475 and 0.309 mm2, respectively. Thus high-cholesterol diet increased the thickness of the intimal layer and probucol reduced its effect. There were no significant differences in the areas of the medial layers in these 3 groups. For the examination of the mechanism of the effect of probucol, rabbits were given chow containing 0.5% cholesterol with and without 0.5% probucol (7 rabbits each) and then the numbers of explants from their aortas showing outgrowth were compared. The plasma total cholesterol levels of these two groups were the same. The probucol concentrations in the plasma and aorta of the former group were 18.6 +/- 13.2 micrograms/ml and 7.3 +/- 5.4 micrograms/g wet tissue, respectively. The number of explants showing outgrowth on day 14 was suppressed by 34% in the probucol-treated group.(ABSTRACT TRUNCATED AT 250 WORDS)