女性海水浸泡严重创伤的救治

目的掌握女性海水浸泡严重创伤特点,选择一种好的处理方法。方法 120例女性海水浸泡严重创伤患者随机分成两组,对照组60例采用常规治疗,包括现场急救、手术和纠正高渗、高钠、高氯血症、纠正酸中毒和抗感染;治疗组60例在常规治疗的基础上加地塞米松、甲状腺素片、心理干预、鲁米那（Luminal）和帕罗西汀（Paroxetine）。观察伤口感染情况和临床治疗结果,对两组结果进行比较。结果对照组伤口感染率为35.0%,格拉斯哥评分（Glasgow outcome scale,GOS）优良率为51.6%;治疗组伤口感染率为12.0%,优良率为81.7%,治疗组伤口感染率和格拉斯哥评分优良率各项指标均优于对照组（P〈0.01）。结论海水浸泡女性严重创伤具有伤因多、部位多、伤情重、创伤后应激障碍的发生率高而严重、救护与救治难度大、死、残率高的特点,救治时应进行针对性处理。

Treatment on Female with Severe Trauma with Seawater Immersion

Objective To grasp the characteristics of female with severe trauma with seawater immersion, in order to choose a good treatment method.Methods A total of 120 female patients with severe trauma of seawater immersion in the wounded were randomly divided into two groups treated with routine methods including early first aid, surgical opera tion, correction of electrolyte imbalance and metabolic acidosis and anti-infection （control group, 60 cases） and treatment group treated by routine treatment plus dexamethasone, thyroxine,luminal, paroxetine and psychological intervention （60 cases） . The wounds and clinical results were observed and compared between the two groups.Results The wounds infec tion rates and good recovery rates of grade with Glasgow outcome scale（GOS ）was 35.0% and 51.6% in the control group, and 12.0% and 81.7% in the treatment group, which were better in the treatment group than in the control group （P〈0.01）.Conclusion The main clinical characteristics of female with severe trauma with seawater immersion include multiple injury factors and traumatic locations, injury severity, high occurrence of post traumatic stress disorders （PTSD） ,difficulty in rescue and treatment and high mortality and crippled rate, which should be specifically focused during the treatment.