批量危重烧伤患者院内二次检伤分诊管理的研究进展

doi:10.3761/j.issn.2096-7446.2025.09.010

摘要/Abstract

摘要：

二次检伤分诊是批量烧伤患者救治中的关键环节。高效的二次检伤分诊，可在批量危重烧伤患者救治中，最大程度上挽救生命、改善预后，保障医疗系统平稳运行。该文从批量危重烧伤患者二次检伤分诊的概述、专科主导的多学科协同二次检伤分诊模式、基于病死率及预后风险的伤情评估及多元理论框架驱动的二次检伤分诊决策4个方面进行综述。未来应在建立符合中国国情与临床实践的标准化救治规范与指南体系方面做进一步研究。

关键词: 批量伤, 烧伤, 大规模伤亡事件, 危重病, 二次检伤, 灾害护理

Abstract:

As secondary triage constitutes a critical component in the management of mass burn casualties. Efficient secondary triage can maximize life-saving potential，improve prognosis，and ensure stable operation of healthcare systems during mass critical burn casualty management. This article will provide a review from four aspects：an overview of secondary triage for mass critically burned patients，a specialty-led multidisciplinary secondary triage collaboration model，an injury assessment method based on mortality and burn prognosis risk，and a secondary triage decision-making process driven by a multi-dimensional theoretical framework. Future research should focus on establishing standardized treatment protocols and guideline systems that are compatible with China’s national conditions and clinical practice.

Key words: Mass Casualty, Burns, Mass Casualty Incidents, Critical Illness, Secondary Triage, Disaster Nursing

赵佳义, 王淑君, 祝红娟. 批量危重烧伤患者院内二次检伤分诊管理的研究进展[J]. 中华急危重症护理杂志, 2025, 6(9): 1089-1093.

ZHAO Jiayi, WANG Shujun, ZHU Hongjuan. Research progress on hospital secondary triage of massive critical burn injuries[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1089-1093.

图/表 2

参考文献 23

[1]	Fuzaylov G, Dabek RJ, Bojovic B, et al. Experience of outreach in a resource-constrained environment:10 years of outcomes in burn care[J]. Burns, 2021, 47(7):1656-1664.
[2]	Perez KG, Eskridge SL, Clouser MC, et al. Burn injuries in US service members:2001-2018[J]. Burns, 2023, 49(2):461-466.
[3]	冯苹, 刘晓彬, 唐洪泰, 等. 成批烧伤救治时护理工作模式[J]. 中华烧伤杂志, 2021, 37(1):79-81.
	Feng P, Liu XB, Tang HT, et al. Nursing work mode in the treatment of massive burn casualties[J]. Chin J Burns, 2021, 37(1):79-81.
[4]	唐乾利. 新中国烧伤治疗技术70年发展与展望[J]. 中国烧伤创疡杂志, 2019, 31(5):305-311.
	Tang QL. Development and prospect of burn treatment technologies over the past 70 years[J]. Chin J Burns Wounds Surf Ulcers, 2019, 31(5):305-311.
[5]	Fuchko D, King-Shier K, Gabriel V. Burn mass casualty incident planning in Alberta:a case study[J]. Burns, 2024, 50(5):1128-1137.
[6]	Hughes A, Almeland SK, Leclerc T, et al. Recommendations for burns care in mass casualty incidents:WHO Emergency Medical Teams Technical Working Group on Burns(WHO TWGB) 2017-2020[J]. Burns, 2021, 47(2):349-370. doi: 10.1016/j.burns.2020.07.001 pmid: 33041154
[7]	Leclerc T, Sjöberg F, Jennes S, et al. European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan[J]. Burns, 2023, 49(2):275-303.
[8]	Curtis EE, Yenikomshian HA, Carrougher GJ, et al. Early patient deaths after transfer to a regional burn center[J]. Burns, 2020, 46(1):97-103. doi: S0305-4179(18)31018-0 pmid: 31859086
[9]	Al-Shamsi M, Moitinho de Almeida M, Nyanchoka L, et al. Assessment of the capacity and capability of burn centers to respond to burn disasters in Belgium:a mixed-method study[J]. J Burn Care Res, 2019, 40(6):869-877. doi: 10.1093/jbcr/irz105 pmid: 31211825
[10]	贺全勇. 成批烧伤的应急救治进展[J]. 中国烧伤创疡杂志, 2021, 33(4):229-232.
	He QY. Progress in emergency treatment for mass burns[J]. Chin J Burns Wounds Surf Ulcers, 2021, 33(4):229-232.
[11]	王晓洁, 高红梅. SBAR沟通模式在患者转运交接中的研究现状[J]. 护理实践与研究, 2018, 15(14):18-21.
	Wang XJ, Gao HM. Research status of the SBAR communication model in patient transport handover[J]. Nurs Pract Res, 2018, 15(14):18-21.
[12]	Usmani A, Pipal DK, Bagla H, et al. Prediction of mortality in acute thermal burn patients using the abbreviated burn severity index score:a single-center experience[J]. Cureus, 2022, 14(6):e26161.
[13]	Saadat GH, Toor R, Mazhar F, et al. Severe burn injury:body mass index and the Baux score[J]. Burns, 2021, 47(1):72-77.
[14]	陈华勇, 辛国华. 烧伤患者预后相关预测模型的研究进展[J]. 中华烧伤与创面修复杂志, 2023, 39(9):891-895.
	Chen HY, Xin GH. Research progress on prognostic prediction models for burn patients[J]. Chin J Burns Wound Repair, 2023, 39(9):891-895.
[15]	Surowiecka-Pastewka A, Witkowski W, Kawecki M. A new triage method for burn disasters:fast triage in burns(FTB)[J]. Med Sci Monit, 2018, 24:1894-1901.
[16]	谢滔. 自建《烧创伤伤情评估表》在批量烧创伤伤员急诊救治中的应用[J]. 国际护理学杂志, 2020, 39(6):1117-1120.
	Xie T. Application of a self-developed “Burn and trauma assessment form” in emergency treatment of mass burn and trauma casualties[J]. Int J Nurs, 2020, 39(6):1117-1120.
[17]	马超群, 赖锦佳, 文工圳, 等. 广东省新入职护士灾害护理核心能力潜在剖面及影响因素分析[J]. 军事护理, 2024, 41(11):21-25.
	Ma CQ, Lai JJ, Wen GZ, et al. Latent profiles and influencing factors of core disaster nursing competencies among newly employed nurses in Guangdong province[J]. Nurs J Chin PLA, 2024, 41(11):21-25.
[18]	International Council of Nurses. ICN disaster competency report[EB/OL].(2019-11-15)[2020-08-15]. https://www.icn.ch/sites/default/files/inline-files/ICN_Disaster-Comp-Report_WEB.pdf.
[19]	舒勤. 中国重症创伤护理:回顾与展望[J]. 创伤外科杂志, 2025, 27(2):81-89.
	Shu Q. Intensive trauma nursing in China:review and prospects[J]. J Trauma Surg, 2025, 27(2):81-89.
[20]	武作家, 王钰炜, 程晶, 等. 创伤救治护理培训的改革与实践成效[J]. 中华护理教育, 2025, 22(1):85-90.
	Wu ZJ, Wang YW, Cheng J, et al. Reform and practical effectiveness of trauma care training[J]. Chin J Nurs Edu, 2025, 22(1):85-90.
[21]	张芳兰. 急危重症护理相关理论与实践应用[J]. 中国防痨杂志, 2024, 46(3):368.
	Zhang FL. Theories and practical applications of critical care nursing[J]. Chin J Antituberc, 2024, 46(3):368.
[22]	April MD, Bridwell RE, Jones J, et al. Descriptive analysis of casualties rapidly returned to the fight after injury:reverse triage implications for large scale combat operations[J]. Med J(Ft Sam Houst Tex), 2022:3-9.
[23]	Remondelli MH, Remick KN, Shackelford SA, et al. Casualty care implications of large-scale combat operations[J]. J Trauma Acute Care Surg, 2023, 95(2S Suppl 1):S180-S184. doi: 10.1097/TA.0000000000004063 pmid: 37420334