汶川地震挤压伤患者获救后快速死亡的原因探讨

目的 探讨"5.12"汶川地震伤员救治过程中,挤压伤患者获救后快速死亡的原因.方法 回顾性分析我院医疗队在灾后早期救治及转运的患者共417例.所有患者均依据当时具体情况行积极现场抢救,对于病情较重者则安排转运至后方有条件的医院继续诊治.结果 救治伤员中,成人355例,儿童62例,年龄8～63岁,平均(37±9.6)岁.其中挤压伤患者117例(男79例,女38例),死亡13例(11.1%).除5例挤压伤患者因原发创伤严重于救治过程中死亡外,其余8例患者救出前一般情况均较好,神智清醒,对答切题,但于废墟下救出后短时间内(<1 h)即因呼吸心跳骤停而死亡.结论 地震后挤压伤患者快速死亡原因多为挤压综合征所致的高钾血症.积极有效地治疗挤压伤患者可减少地震后死亡人数.

Investigation of causes of rapid death after rescue among patients suffering crush injury after Wenchuan earthquake

Objective To investigate the causes of rapid death after rescue among patients suffering crush injury after Wenchuan earthquake. Method A retrospective analysis of the medical records of 417 earthquake victims who remedied and transferred by our medical team was made. All patients were salvaged at scene according to the situation at that time and severe patients were transferred to undamaged peripheral general hospitals for continued treatment. Results A total of 417 patients (355 adults and 62 children) with earthquake related injuries and illness were admitted to our medical team. The mean age was (37± 9.6) years. There were 117 crush injury patients (79 male and 38 female) among those patients. The mortality of crush injury was 11.1% (13/117). Among the dead cases, five died of severe primary injury and the other 8 patients with sudden rapid death within 1 h after removal of compressive forces. Conclusions Hyperkalemia and its associated cardiotoxicity were the most common cause of rapid deaths after rescue among patients suffering crush injury after earthquake. Effective treatment of crush injury patients remains one of the most important measures in decreasing earthquake-related death rate.