肖建军 张民 郭海龙 刘岩 夏涛

[摘要] 严重的创伤不仅给伤者身体造成严重的伤害甚至可能导致死亡，同时对伤者的心理也造成严重的创伤。合理的急救措施，不仅能使伤者生命得到保障也使伤者的心理得到极大的安慰。车祸现场的的救治首要任务是缓解患者的疼痛，使患者处于安静状态以减少应激反应的发生。帕瑞昔布钠复合亚麻醉剂量的氯胺酮不仅能使伤者疼痛减轻，同时也可以使患者处于安静状态，在车祸现场的救治中能起到非常重要的作用。

[关键词] 帕瑞昔布钠；亚麻醉剂量；氯胺酮；急救；事故

[中图分类号] R971.2[文献标识码] B[文章编号]1673-7210（2011）11（c）-165-02

The application of Parecoxib Sodium combined with sub-anesthetic dose of Ketamine in one case of accidentemergency treatment

XIAO Jianjun, ZHANG Min, GUO Hailong, LIU yan, XIA Tao

Department of Anesthesiology, Huainan Xinhua Hospital, Anhui Province, Huainan 232052, China

[Abstract] Severe trauma leads to serious bodily harm even death, and also causes critical psychological injury of wounded patients. Suitable emergency treatment not only can guarantee the life of wounded patients, but also comfort their psychology. The first aim of the emergence treatment in the traffic accident is alleviating the pain of wounded patients and keeping them calm, in order to reduce the stress. Parecoxib Sodium combined with sub-anesthetic doses of Ketamine can not also relieve the pain of the wounded but also keep them calm, which plays an important role in emergency treatment of traffic accident.

[Key words] Parecoxib Sodium; Subanesthetic dose; Ketamine; Emergency treatment; Accident

随着社会不断的发展，我国已成为世界上拥有机动车辆最多的国家，然而机动车带来的交通事故也屡见不鲜。以往交通事故的救治中往往是将伤者送到手术室后才对其进行镇痛及麻醉，使患者较长时间的承受剧烈疼痛与心理压力，同时也减慢了救援速度。本文笔者在肇事现场充分权衡利弊果断对伤者实施了现场麻醉，最终取得非常满意的效果。现报道如下：

1 一般资料

2011年6月16日11时20分左右在安徽省淮南市淮凤公路孔集段发生一起严重交通事故。伤者侯某，男，42岁，65 kg，经医生初步诊断为车祸腹部贯通伤。现场发现一长3 m横断面面积约8 cm×8 cm的方形钢管刺穿车头贯通伤者腹部进入车厢。患者查体：神清，极度痛苦貌，呼吸频率24次/min，心率110次/min，血压135/80 mm Hg（1 mm Hg=0.133 kPa），询问伤者既往身体情况良好，否认手术外伤史、传染病及遗传性疾病史，无药物食物过敏史。……