The Exploratory Development Of Blunt Abdominal Trauma Of The War Outside The Hospital Early Treatment

At present, the remedy of abdominal trauma about battle injury or wound (BIW) and wound(WD) in hospital was more fully and comprehensively, in the two hours after the trauma , obtained the proper treatment in the hospital, about 90% of patients is expected to heal. However, according to statistics, the domestic bleeding abdominal trauma patients, only 30% can be sent to the hospital. Another 70 per cent of patients died of injuries at the scene and en route. There are mainly two reasons: First, emergency hospital network distribution, in the Mainland of China's urbanization distance of about 60 kilometers, mostly in remote areas more than 100 kilometers, and hospitals located in a busy section of town, the majority of traffic is not clear, in most cases where staff arrived at the scene about a half hour or more, patients will be transported to the hospital about 1:30 about a small, remote areas require a longer time. Second, the scene of the emergency situation at home and abroad on the scene of blunt abdominal trauma visceral bleeding where relatively little research in the former emergency personnel arrived on the scene almost no first aid measures, and emergency personnel arrived at the scene and only can do merely establishment of intravenous access, and rapid evacuation. In addition to watching the whole process of excessive bleeding in patients with serious condition, and helpless.Versus trauma patients with pain treatment is the most pressing needs of the subjective, patient communication is a good start, but also with the evaluation of the first indicators. Especially in the war, trauma first aid in the early stage of enhanced combat effectiveness and reduce casualties panic, where increased efficiency of major significance. However, for the treatment of abdominal trauma pain medication and treatment time for us, no clinically proven methods and norms. As concerns early pain will cover illness or more inflammatory response, and the part of doctors and patients to consider using excessive analgesics such as pethidine addiction, lead to widespread clinical analgesic time later, many patients are dissatisfied with the treatment of pain.In view of the above problems, and study conducted in two parts:PartⅠ: The exploratory of Blunt abdominal trauma hemorrhage war in the early treatmentObjective: To approach the possibility and the mechanism of the application of abdominal pressurize in abdominal trauma hemorrhage emergency. Methods: Mesenteric artery surgery cut off arterial catheterization and abdominal internal drainage tube, producing blunt abdominal trauma mesenteric artery bleeding animal model of rabbits were randomly divided into two groups, simple hemorrhagic (T) group and abdominal compression, processing (P) Group simple hemorrhagic (T) by the first group to the drainage tube intraperitoneal infusion balanced salt to drainage tube can not be imported will be open drainage, the importation of liquid record total. After intra-arterial catheter Bloodletting, when the total amount of bleeding and transfusion to a halt, rabbits observation of vital signs, records from the beginning of the rabbits bleeding to death and the survival time of the amount of bleeding and speed. When the rabbits were killed stop experiments. Treatment of abdominal pressure (P) group: first medical device used to rabbits abdominal pressure, the pressure gauge showed 7.5 mmHg. And do simple blood loss and dealing with the same group.Results: The mean survival time of the disposal group, was longer manifest than the mean survival time of the control group. The difference between the two groups was significant.Conclusion: Simple hemorrhagic group rabbits average amount of bleeding was 36.6±1.3ml, the average rate of bleeding 4±0.15ml/min, the average survival time was 13.3±0.2min; abdominal pressure-treated group, the average amount of bleeding rabbits to 25.3±3.3ml, The average rate of bleeding 3.3±0.1ml/min, the average survival time was 2.76±0.6h; abdominal pressure-treated group, the average survival time of rabbits, significantly higher than pure trauma group rabbits average survival time.PartⅡ: The exploratory of Blunt abdominal trauma war in the early treatment of painAbstract: Early observation of the surface of lidocaine injection pethidine narcotic analgesics and blunt abdominal trauma on the body early acute inflammatory response to different levels of impact assessment early lidocaine surface narcotic analgesics in clinical availability.Methods: Rabbits by surgery suture cutting production by the liver and intestinal rupture caused by blunt abdominal trauma of the animals were randomly divided into three groups, each 12.①simple trauma (T) group: five minutes after trauma to the intraperitoneal injection of sterile saline 5 ml, and 2 h and 4 h after injection repeat 2.②lidocaine (L) treatment groups: post-traumatic five minutes from the incision to the intraperitoneal injection of 1% lidocaine 5 ml, and 2 h and 4 h after injection repeat 2.③pethidine (P) treatment groups: five minutes after trauma, intramuscular pethidine 5 mg / kg, and 2 h and 4 h after injection repeat 2.Result : Post-traumatic one hour, three groups of rabbits total number of leukocytes in the blood, neutrophil percentage of human tumor necrosis factor alpha (TNF-α) were higher than before the trauma, the group were significantly different (P <0.05 ), lidocaine (L) of the treatment group were less than the average observed only trauma (T) group, pethidine (P) of the treated group were observed more than simple average of trauma (T) group, group had a significant difference (P <0.05). Simple trauma after trauma (T) group neutrophil percentage of TNF-αconcentrations of 1,3,5 h level there was no significant difference, lidocaine (L) treated neutrophil percentage of TNF-αconcentrations of 1,3, 5h level of a declining trend; pethidine (P) treated neutrophil percentage of TNF-αconcentrations of 1,3,5 h level there was no significant difference.Conclusion: Early intraperitoneal injection of lidocaine through the pain may be sympathetic - adrenomedullin system peripheral response systems, vascular changes in body condition, improve blood flow traumatic parts of the state, but also may be passed on the body and the biochemical reaction of the role of the immune system to reduce inflammatory reaction, and help to promote inflammation improved results, intramuscular pethidine made the inflammatory response to the degree of stability in a relatively high level.