创伤外科发展的机遇和挑战-白祥军.pdf

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1、创伤外科发展的机遇与挑战同济医学院附属同济医院华中科技大学同济咸宁医院白祥军白祥军教授主任医师博士生导师华中科技大学同济医学院附属同济医院创伤外科主任、急救中心主任同济咸宁医院院长/党委副书记中华医学会创伤学分会常委创伤急救与多发伤专业委员会副组长中华医学会急诊医学分会创伤组副组长《临床急诊》《创伤外科》副主编《中华急诊医学杂志》编委《中华创伤杂志》+英文版编委《Notfall+Rettungsmedizin》海外编委德国急救医学TraumaEpidemiology–InChina中国创伤之现状“Trauma:AnUnder-recogni

2、zedPublicHealthProbleminModernSociety.”---founderofMarylandShockTraumaCenterR.AdamsCowley“创伤是一个被现代社会忽视的公共卫生问题”TraumaEpidemiology–AroundtheWorld2012WHOStatisticalDataRatioofTraumainWorldwideDeathCases伤害是青壮年死亡主要原因TraumaEpidemiology–InChinaLethalinjuryisjustthetipoftheiceberg

3、！每年因各类伤害死亡约70万人，但仅仅是冰山一角Nonfatalinjuryleadtolong-termandheavyburden!致伤致残则以千万计，生存质量不高InjurypatternforChineseresidentsDatafrom:Injury-relatedfatalitiesinChina:anunder-recognisedpublic-healthproblem.Lancet.2008Nov15;372(9651):1765-73TraumaEpidemiology–InChinaDatafrom:ChinaHea

4、lthStatisticalYearbook2012TraumaEpidemiology–InChinaadmissionratemortality创伤是县级医院主要病种和主要死亡原因Bothadmissionrateandmortalityinbasichospitalsaremuchhigherthanthatinlarge-scalehospitals!Datafrom：李继光.辽宁省不同规模医院住院疾病谱对比分析.中国医院管理TraumaRescueSysteminChinaPre-hospital—EmergencyRoom—In

5、-hospital院前急救—急诊科救治—院内专科的救治Pre-hospitalRescue--metropolisCommandermode(Beijing,Guangzhou):Emergencycenter,asthecommanderandwithoutrescuefunctionbyitself,appointsemergencyunitsfromdifferenthospitalsforrescuetask.Affiliationmode(Chongqing):Emergencycenterisaffiliatedtoalar

6、ge-scalehospitalandownspre-andinhospitalrescueunitsbyitself.CommandandCooperationmode(Shanghai):Emergencycenteranditssubstationstakechargeofpre-hospitalrescuethentransferpatientstocooperativehospitalforfurtherrescue.RescuenetworkisBeijingemergencynetworkChongqingemergency

7、centerbasicallysetupinmetropolis.大城市急救网络相对完善Pre-hospitalRescue--metropolisLimitationsLackofemergencyphysiciansandLackofinformationexchangeandATLStrainingalarminrescuechain急救从业人员数量不足且水平参差不齐院前120-急诊科（医院）信息交换及预警系统缺失vacancyPre-hospitalRescue--metropolisLimitationsTrafficjaming

8、roundaidAirrescuesystemhasalongwaytogo地面交通拥堵空中急救落后Pre-hospitalRescue--countrylevelPre-hos