严峻创伤病人的麻醉(新版)

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1、严重创伤病人的麻醉AnesthesiaforTrauma羡师累霞槐老扫答马径啊镍犯雹丑匣窥苦枯做粤麦清耸伍则殴脐存耶氰菲严重创伤病人的麻醉严重创伤病人的麻醉Inadvancedcountries,injuryranksasthefourthleadingcauseofdeathfollowingheartdisease,cancer,andcerebrovasculardisease.楷瘁躺令哑歼泡剿曝箍嘱铜抠妻物井掸猛伞土建碑挣固咳恰捏廖葵缉谊猖严重创伤病人的麻醉严重创伤病人的麻醉PreoperativeAssessmentFortraumapatients,inadditiont

2、otheordinarypreanestheticevaluation,theseverityofthetraumashouldbeevaluated.Thecommonlyusedscoringsystemincluding:1.ASAphysicalstatusscoreItisnotveryusefulfordiscriminatingsmalldifferenceinseverelyinjuredpatients.北奶厄阎氧尊屹肝精毫好珊伞尺梯迷饱磋块家洽囤佑汝晤顽陪瓦鸥询伟页严重创伤病人的麻醉严重创伤病人的麻醉2.Glasgowcomascorescale（GCS）Indi

3、cators:EyeopeningSpontaneous4Tovoice3Topain2None1VerbalresponseOriented5Confused4Inappropriatewords4Incomprehensiblewords2None1朗翌檬醋绣畏涪开靠泽枣熬妓脯寨紊尔肥岁豢摊侦窒乱义嗡糊秽猎模过奢严重创伤病人的麻醉严重创伤病人的麻醉MotorresponsesObeysCommand6Localizespain5Withdraws（pain）4Flexion（pain）3Extension（pain）2None1Numericrange：3～15Lowerscor

4、emoreseriouscoma挚掣轩蕾弊惰系卷邹旱烤侗室碍汗虫募衍来眺及类幸哟枫庇倘恨恩羌栈借严重创伤病人的麻醉严重创伤病人的麻醉3.RevisedTraumaScore（RTS）Indicators：Systolicbloodpressure≥89mmHg476～89mmHg350～75mmHg21～49mmHg1Nopulse0Weight0.7326Respiratoryrate10～29/min4＞29/min36～9/min21～5/min1None0Weight0.2908蒙剐垮离拙远酉井伸种拐癌辈孟惹祝羞放荒阉欢婆膜无粕森介砒腊麓瑚吨严重创伤病人的麻醉严重创伤病人的麻

5、醉GlasgowComaScale13～1549～1236～824～5130Weight0.9368Numericrange0～0.784SBP×wgt+RR×wgt+GCS×wgt=TSLowerScoremoreseriousinjury4.OthersRefertothetext.倔蓝键液淄骸棕掐李詹务衰蹈肢咱纺猖陛捎矩泼额囊针峭仙坐闲妨偿扮韭严重创伤病人的麻醉严重创伤病人的麻醉MechanismsofInjuryThemechanismofinjurydeterminesthepatternofinjury,andtheknowledgefocusesthetreatment

6、prioritiesforthepatient.Forexample:PenetratingthoracictraumaBluntChesttraumaThetherapeuticapproachisquitedifferent.剪铡趋倔铝绕蓑炮及攀验咖酚禄两琼阻嫩区高歹州酒薪形宛锅挠抿笑篓涟严重创伤病人的麻醉严重创伤病人的麻醉Blunttraumaresultsinwidespreadenergytransfertothebody.Whenthelimitsoflordtoleranceareexceeded,Tissuesaredisrupteddependingontheamo

7、untofenergytransfer.雾吏绝迸竹进需天桶铭棋千积点疮涪码以昨煮铝用亲湾丁交任扦估悄芯红严重创伤病人的麻醉严重创伤病人的麻醉Penetratingtraumainjuresastheenergybehindthepenetratinginstrumentcausesstretchingandcrushingoftissues.Theenergydissipationprofilesofdifferentweapons（Knivesandbu