初始稳定的钝挫伤或穿透性损伤儿童的治疗
- Authors
- Lois K Lee, MD, MPH
Lois K Lee, MD, MPH
- Assistant Professor of Pediatrics
- Harvard Medical School
- Gary R Fleisher, MD
Gary R Fleisher, MD
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Pediatric Signs and Symptoms
- Egan Family Foundation Professor
- Harvard Medical School
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
- Translators
- 王学明, 副主任医师
王学明, 副主任医师
- 首都医科大学附属北京朝阳医院急诊科
引言
本文将总结发生创伤性伤害但情况稳定的儿童的初始治疗。对于情况不稳定的儿童，其创伤的治疗将单独讨论。 (参见“创伤治疗：对情况不稳定儿童的处理”)
术语
在本专题中，稳定性儿科创伤患者指损伤后初期生命体征正常或基本正常、机体功能正常(气道、呼吸、循环、精神状态)且没有明显危重损伤的受伤儿童。在评估生命体征时，创伤救援人员必须采用针对儿童(而不是成人)的正常参考值(表 1)(计算器 1和计算器 2)。 (参见“创伤管理：儿科的特殊注意事项”)
很多最终需住院和/或进行手术治疗的严重损伤的儿童，最初可看似病情稳定。急救人员有责任根据损伤的机制和体格检查的结果，对初始看似稳定的创伤儿童进行详细评估，并发现那些严重创伤的风险较高的患者(表 2和表 3)。
损伤的分类
外伤性创伤的严重程度从轻微至致命性不等。目前已有几种判断创伤严重程度的方法。为对创伤患者的处理进行恰当分类，一种有用的方法是使用如下参数对损伤进行分类。 (参见“儿童创伤分类”)
损伤的范围 — 多发性创伤指身体两处或更多处存在明显损伤。局限性创伤仅涉及身体的一个解剖学区域(如，头颈部、胸背部、腹部、四肢)。有时损伤的范围可能很明显；但有时损伤可能不容易被发现，临床表现可能随时间的延长而进展。
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-06-22.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Lavoie M, Nance ML. An approach to the injured child. In: Fleisher & Ludwig's Textbook of Pediatric Medicine, 7th ed, Bachur RG, Shaw KN (Eds), Lippincott Williams & Wilkins, Philadelphia 2015. p.9.
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