创伤和战伤 中山大学 外科学.ppt

Trauma Weapon Injury Qing-Tang Zhu, M.D., Ph.D. Department of Microsurgery Orthopedic Trauma The First Affiliated Hospital Sun Yat-Sen University Aims of this lecture Know the physiological responses of our bodies following trauma Know the features of different types of trauma Learn how to care an acutely injured patient based on the priority Know some general knowledge about weapon injury Outline Part I: Basic scientific knowledge about trauma Pathophysiology of trauma Wound healing Part II: Trauma Epidemiology injury prevention Classification triage Initial assessment care Part III: Weapon Injury Blast injury Nuclear weapon injury Chemical weapon injury Combined injury Part I: Basic scientific knowledge about trauma Pathophysiology of trauma Immune response to trauma Changes in organ function following trauma Wound healing Immune Response to Trauma Dynamic stages in the immune response to trauma Changes in organ function Cardiovascular system Blood loss, hypovolemia, shock, hear failure Lung Hypercapnia Hypoxia Adult Respiratory Distress Syndrome (ARDS) Acute Lung Injury (ALI) Kidney Hypovolemia, renal hypoperfusion, Toxin-mediated (radiocontrast, antimicrobials) renal parenchymal injury Rhabdomyolysis Liver Gastrointestinal tract: bleeding Brain Wound Healing Part II: Trauma Epidemiology injury prevention Classification trauma triage Initial assessment and care of the injured patient Prehospital phase In-hospital phase The Facts about Trauma Leading cause of death Over all ages: Rank 4 Aged 1 to 44: Rank 1 Aged 1-34: more than to all other causes of death combined Nonfatal Injuries (USA, 2003) 8% of all hospital discharges 37% of all emergency department visits The highest rate of injury In developing areas/countries Rapid economic change and urbanization Road traffic incidence caused Global: 1.18 million deaths; 30 million injuries USA: 45,000 deaths; 357,000 hospitalization China: 120,000 deaths; 550,000 injures Lifetime Cost of Injury$4