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中华卫生应急电子杂志 ›› 2017, Vol. 03 ›› Issue (02) : 65 -71. doi: 10.3877/cma.j.issn.2095-9133.2017.02.001

所属专题: 文献 指南共识

专家共识

批量伤员感染预防策略专家共识(2017)
中国研究型医院学会卫生应急学专业委员会, 中国中西医结合学会灾害医学专业委员会, 重庆市中西医结合学会灾害医学专业委员会   
  • 收稿日期:2017-03-28 出版日期:2017-04-18
  • 基金资助:
    军队十二五重点项目(BWS11J038); 军队特需药品保密专项(2014ZX09J14107-08C); 国家自然科学基金面上项目(81671906)

Expert consensus on prevention strategies for batch infections (2017)

Hygiene Rescue Committee, China Academy of Research Hospital, Disater Medicine Committee, China Society of Integrated Traditional Chinese and Western Medicine, Specialized Committee of Disaster Medicine, Chongqing Association of Integrated Traditional Chinese and Western Medicine   

  • Received:2017-03-28 Published:2017-04-18
引用本文:

中国研究型医院学会卫生应急学专业委员会, 中国中西医结合学会灾害医学专业委员会, 重庆市中西医结合学会灾害医学专业委员会. 批量伤员感染预防策略专家共识(2017)[J]. 中华卫生应急电子杂志, 2017, 03(02): 65-71.

Hygiene Rescue Committee, China Academy of Research Hospital, Disater Medicine Committee, China Society of Integrated Traditional Chinese and Western Medicine, Specialized Committee of Disaster Medicine, Chongqing Association of Integrated Traditional Chinese and Western Medicine. Expert consensus on prevention strategies for batch infections (2017)[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2017, 03(02): 65-71.

表1 战创伤感染预防措施时效规划表
表2 维生素B6联用20AA复方氨基酸(丰诺安)的新疗法具体用法
表3 国际红十字委员会抗生素使用协议
损伤类型 抗生素 备注
无并发症的轻微软组织损伤(Ⅰ级) 青霉素-V(片剂500 mg口服,4次/d,连续5 d) 对所有武器伤伤员实行抗破伤风措施
复合性骨折 青霉素-G(5 MIU静脉滴注,4次/d,连续48 h) 中厚皮片移植缝合伤口后应继续使用青霉素-V 5 d在重新清创而非伤口延迟缝合的情况下,应停止使用抗生素,除非有全身性感染或局部炎症的征象-在后一种情况下,加入甲硝唑(500 mg静脉滴注,3次/d)和庆大霉素(80 mg静脉滴注,3次/d)
外伤性截肢 续用青霉素-V(片剂500 mg口服,4次/d)直至伤口延迟缝合
重大软组织损伤(Ⅱ级、Ⅲ级)
延迟超过72h的复合性骨折或重大软组织损伤 青霉素-G(5 MIU静脉滴注,4次/d)和甲硝唑(500mg静脉滴注,3次/d, 48 h)
由杀伤性地雷造成、因各种原因延迟救治的四肢伤 续用青霉素-V(片剂500 mg口服,4次/d)和甲硝唑片剂(500 mg口服,3次/d)直至伤口延迟缝合
血胸 氨苄青霉素(1 g静脉滴注,4次/d,48 h),接着用阿莫西林片剂(500 mg口服,4次/d) 继续使用抗生素直至拔出胸导管后2 d
穿透性颅脑创伤 青霉素-G(5 MIU静脉滴注,4次/d)和氯霉素(1g静脉滴注,3次/d)至少72 h 持续静注或口服药物10 d
脑脓肿 与穿透性颅脑损伤使用同样的药物,加上甲硝唑(500 mg静脉滴注,3次/d) ?
眼球穿透伤 青霉素-G(5 MIU静脉滴注,4次/d)和氯霉素( 1g静脉滴注,3次/d,48 h) 持续静注或口服药物10 d,滴抗生素眼药水
颌面创伤 氨苄青霉素(1g静脉滴注,4次/d)和甲硝唑(500 mg静脉滴注,3次/d,48 h) 持续静注或口服药物5 d
腹部伤口: 1.青霉素-G(5 MIU静脉滴注,4次/d) 根据引流情况持续用药3 d
1.实体器官只有:肝,脾,肾或分离膀胱损伤 2.氨苄青霉素(1 g静脉滴注,4次/d)和甲硝唑(500 mg静脉滴注,3次/d)
2.胃,小肠 3.氨苄青霉素(1 g静脉滴注,4次/d)和甲硝唑(500 mg静脉滴注,3次/d)和庆大霉素(80 mg静脉滴注,3次/d)
3.结肠,直肠,肛门
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