挤压伤和挤压综合征

摘要

Natural or technological disasters are always accompanied by trauma ,of which crush injury is a common type .Patients may die from crush injury in disaster scene directly or from systemic conditions such as shock,hyperkaliemia and acute renal failure secondly to crush syndrome .Rapid progression,undervaluation and in-appropriate treatment of crush syndrome usually lead to preventable disability and death .Early diagnosis and thera-py are the key point to reduce mortality in crush injury patients .Pre-hospital rescue mainly includes fluid adminis-tration,medications and wound management , while in-hospital therapy is characterized by hemodialysis . In fact, there is still no standard guideline for crush syndrome due to existence of various disputes ,so individual treatment is needed according to specific conditions .%创伤总是与自然或人为灾害紧密相关，挤压伤是其中较为常见的一类。挤压伤不仅直接导致伤员死于灾害现场，还可能导致幸存者出现挤压综合征，最终继发死于休克、高钾血症、急性肾功能衰竭等一系列全身并发症。一方面挤压综合征病程进展迅速，另一方面救援者对其认识不足或处理措施不当，从而导致了本可以预防的残疾和死亡。早期诊断和治疗是提高挤压伤患者生存率的关键，院前急救主要包括补液、药物治疗和患肢局部处理，而院内救治的关键是血液净化。挤压综合征的救治目前仍存在诸多争议，国内外尚无标准化方案，需根据患者具体情况进行个性化处理。