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2006/11/20 04:09記者: 黃庭郁/台北報導
邵曉鈴車禍重傷急遽惡化,台灣急診醫學會榮譽理事長、長庚醫院急診部主任陳日昌說,八十五%的嚴重多重外傷患者根本未及時送醫,僅一到二成有機會送急診搶救。這類嚴重傷患全身多處有傷,就算搶救一處也未必足以停止他處傷勢繼續進展,處理十分棘手。
陳日昌說,高速撞擊下,傷患肢體遭力量強大的拉扯,幾乎全身各處都有可能受傷,醫院勢必依各部位傷勢分段處理,並依照失血狀況輸血。
以斷臂為例,在傷及大動脈的最壞狀況下,患者大量失血根本止不住。以最保守的三十分鐘運送時間推估,患者很可能根本撐不到醫院。
假使患者能及時送院,並穩住血壓,推測第一時間的失血量應在還有辦法搶救的範圍,醫師多半會先考慮截肢保命,若企圖保留則挑戰更大。
多重外傷棘手的不僅如此,陳日昌說,很多腹腔、頭顱出血,剛開始不明顯,診斷不易。以致傷患搶救告一段落,不久又出現另一波惡化。
外界對邵曉鈴接受一萬三千多西西的大輸血感到吃驚,陳日昌說,這在急診並不少見,從片面資料判斷,患者應是斷臂與脾臟出血一直無法止住,而需要分段輸血,以一般全身四千西西血量推估,等於是換了三次血。
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