40例野战火器性胸腹联合伤特点与救护对策

目的总结野战情况下火器性胸腹联合伤的救护特点，探讨未来战争中胸腹联合伤的救护对策。方法对1979年及1984年自卫反击战中火器性胸腹联合伤病历资料进行回顾性调查，专访当年参加救护的医护人员，总结分析野战火器性胸腹联合伤的救护经过。结果40例胸腹联合伤患者中，致伤原因以炮弹伤为主；伤情复杂，合并多脏器损伤，死亡率为13％；感染发生率高达35％。结论根据火器性胸腹联合伤患者的特点采取针对性的救护措施，有利于在未来战争中提高救护水平，改善患者预后。笔者认为应遵循先救命后救伤的原则；尽量做到早期诊断；前线救治以胸腔或腹腔引流为主；进行积极有效的护理；改进救护技术及器材。

The Characteristics and Rescue Measures of 40 Cases of FirearmThoraco-abdominal Injuries in Field Battle

Objective To summarize the characteristics of firearm thoraco-abdominal injuries in field battle and explore the rescue measures in future wars. Methods Medial records of firearm thoraco-abdominal injuries in field battles in 1979 and 1984 Self-defense War, were reviewed retrospectively. Meanwhile, visits and interviews were paid to those medical staff participating in the war. Their rescue experience was summarized. Results Most of the 40 cases of firearm thoraco-abdominal injuries in field battle were caused by gunshots, with their wounds complicated with multiple organ traumas, the death rate amounting to 13% and infection rate to 35%. Conclusion Based on the characteristics of firearm thoraco-abdominal injuries,pertinent nursing measures can contribute a lot to the increase of successful rescue and better outcome. The measures include： early diagnosis; the principal of ＂saving life before treating wounds＂ should be followed in the battlefield rescue; rescue in the frontline should focus on thoracic or abdominal drainage; meanwhile, active and effective nursing care should be taken; the rescue skills and equipment should be improved.