Surgical outcomes of a civil war in a neighbouring country
Surgical outcomes of a civil war in a neighbouring country
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DOI：
10.1136/jramc-2015-000411
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发表时间：
2016-08-01
影响因子：
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通讯作者：
Temiz, M.
中科院分区：
文献类型：
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作者：
Akkucuk, Seckin;Aydogan, A.;Temiz, M.
叙利亚内战于2011年3月15日开始，许多伤者在邻国土耳其接受治疗。本研究报告了这场战争的手术结果，在土耳其的一个三级中心。方法对2011 - 2012年在土耳其哈塔伊穆斯塔法·凯末尔大学医学院研究培训医院普通外科收治的159例叙利亚平民战争伤患者的年龄、性别、损伤类型、既往手术史、腹部损伤类型（实体或腔内器官）、单纯性或多发性腹部损伤情况、死亡率、住院时间、住院时间、住院时间等进行分析。住院时间和损伤严重程度评分。结果患者年龄中位数为30.05岁（18 ~ 66岁）。116例患者中以枪伤为主（99例，85.3%）。初诊患者和既往手术患者转至我院的中位时间分别为6.284.44h和58.11±44.08h。多数患者有肠道损伤；虽然有限数量的结直肠损伤患者接受了初级修复，但由于运输时间延长导致腹膜污染严重，造口是主要的手术选择。两名女性和21名男性死亡。主要死亡原因为败血症继发多器官衰竭（18例）。结论在边境国家发生内战的情况下，建议采取预防措施，例如将附近的民用医院改造为军事医院，并在这些医院雇用经验丰富的创伤外科医生提供有效的医疗服务。损害控制程序可以避免死亡，特别是在致命的生理死亡发生之前。在临近内战的国家，将伤员迅速运送到最近的医疗中心是关键。
Objectives The civil war in Syria began on 15 March 2011, and many of the injured were treated in the neighbouring country of Turkey. This study reports the surgical outcomes of this war, in a tertiary centre in Turkey.Methods 159 patients with civilian war injuries in Syria who were admitted to the General Surgery Department in the Research and Training Hospital of the Medical School of Mustafa Kemal University, Hatay, Turkey, between 2011 and 2012 were analysed regarding the age, sex, injury type, history of previous surgery for the injury, types of abdominal injuries (solid or luminal organ), the status of isolated abdominal injuries or multiple injuries, mortality, length of hospital stay and injury severity scoring.Results The median age of the patients was 30.05 (18-66years) years. Most of the injuries were gunshot wounds (99 of 116 patients, 85.3%). Primary and previously operated patients were transferred to our clinic in a median time of 6.284.44h and 58.11 +/- 44.08h, respectively. Most of the patients had intestinal injuries; although a limited number of patients with colorectal injuries were treated with primary repair, stoma was the major surgical option due to the gross peritoneal contamination secondary to prolonged transport time. Two women and 21 men died. The major cause of death was multiorgan failure secondary to sepsis (18 patients).Conclusions In the case of civil war in the bordering countries, it is recommended that precautions are taken, such as transformation of nearby civilian hospitals into military ones and employment of experienced trauma surgeons in these hospitals to provide effective medical care. Damage control procedures can avoid fatalities especially before the lethal triad of physiological demise occurs. Rapid transport of the wounded to the nearest medical centre is the key point in countries neighbouring a civil war.