汶川地震转运与震区住院患者回顾性对比分析
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摘要
目的:探讨汶川地震转运与震区住院伤病员的特点和疾病谱。方法:采用"军卫一号"医院信息系统,收集整理三所军队医院收治汶川地震伤病员的诊疗信息。对比转运与震区住院伤病员的入院时间、基本情况和诊疗信息的差异。结果:震后第2日震区住院伤病员入院人数最多,为394人;前4日占震后10日内入院人数的80.6%。全部住院伤病员男性730人,占56.5%,女性562人,占43.5%;汉族占95%,羌族、藏族及其他民族占5%;已婚占76.4%;手术率为36.5%;住院天数的中位数为12天;治愈好转率为96.5%,病死率为1%。转运与震区住院伤病员的性别、年龄组、民族、手术与否和治疗结果构成差异具有统计学意义(P<0.05);震区住院伤病员组的住院天数中位数低于转运住院伤病员组(P<0.001)。按照出院第一诊断,损伤或中毒住院伤病员占81.5%;其他疾病前五位为消化系统疾病、呼吸系统疾病、肌肉骨骼和结缔组织疾病、循环系统疾病、症状和体征。结论:地震等灾害后应尽早(灾后3-5天)转运伤病员。震区一线医院和接收转运伤病员医院应科学、合理设置床位、安排陪护人员、招募志愿者。地震第一阶段医疗救援完成后,救援重点应转向内科和慢性疾病,并提前做好应医疗准备。
Objective: To investigate the characteristics and disease spectrum of the medevac patients and patients admitted in earthquake area in Wenchuan earthquake.Methods: The clinical information of Wenchuan earthquake inpatients in the three hospitals was searched and collected in "Junwei No.1" hospital information system.The admission times,the basic and clinical information were compared between the medevac patients and patients admitted in earthquake area.Results: On the 2nd day after earthquake,the hospital in the earthquake area admitted the most patients per day,up to 394.The admissions in the first four days accounted for 80.6% of all hospital admissions in 10 days in the earthquake area.There were 730 males,accounting for 56.5%,and 562 females,accounting for 43.5%,in all patients.The proportion of the patients with Han nationality was 95%,and the proportion of the patients with Qiang,Tibetan and other nationality was 5%.The proportion of the married patients was 76.4%.The operation rate was 36.5%.The median of the days in hospital was 12.The cure and improvement rate was 96.5%.The fatality rate was 1%.The proportions of the gender,age group,nationality,surgery or not,and treatment outcomes of the patients were significantly different between the medevac patients and patients admitted in earthquake area(P <0.05).The median of the days in hospital of the patients admitted in earthquake area was lower than that of the medevac patients(P <0.001).The proportion of the patients with injury and poisoning diagnosis was 81.5% in all patients.Besides injury and poisoning diagnosis,the top five diagnoses were diseases of the digestive system,diseases of the respiratory system,diseases of the musculoskeletal system and connective tissue,diseases of the circulatory system;symptoms,signs,and ill-defined conditions.Conclusion: The patients transportation should carry out as soon as possible(3-5 days after the disaster),after earthquake or other any disaster.The front-line hospital and the hospitals receiving transported patients should scientifically and reasonably set the beds,arrange the accompanying persons,and recruit volunteers.Upon the completion of the first phase of medical rescue in the earthquake,the medical rescue focus should be shifted to the internal medicine and chronic disease,and the medical preparation should be done in advance.
引文
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