143例玉树地震藏族伤员临床特点和救治分析
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摘要
目的总结玉树地震藏族伤员的临床特点和救治经验,为健全地震灾害应急预案机制提供决策参考。方法回顾性分析绵阳地震救援队2010年4月16～22日收治的143例玉树地震藏族伤员情况,根据伤员登记表,调查伤员性别、年龄、致伤方式、救援地点、救援时间、主诉、初步诊断、现场处置、转运以及心理危机干预等。结果收治的143例玉树地震藏族伤员中,男74例,女69例,软组织损伤74例,骨折伤员67例(开放性骨折4例,闭合性骨折63例),关节脱位5例,神经损伤3例;采用藏汉疗法结合外固定治疗62例,急诊手术5例,拒绝外科清创缝合6例,无死亡病例。对所有伤员均进行了3～11次心理干预治疗。在伤员转运方面,建议转出54例,实际转出48例,6例失访或拒绝,继续在原地治疗。结论玉树地震藏族伤员的临床特点明显。民族地区灾害医疗救治要适合灾区特点,个体化救治,及早心理干预,是提高非汉语言地震医疗救援整体水平的重要措施。
Objective To analyze clinical characteristics and treatment experience of 143 tibetan victims of China Yushu earthquake,so as to provide reference for emergency preparation for earthquake disasters.Methods A retrospective study from April 16th to April 22th,2010 was designed.A total of 143 injured Tibetans(74 men,69 women) of the magnitude 7.1 Yushu earthquake were included in this study.Data from victims was collected retrospectively as follows: age,gender,cause of injury,place and time of rescue,chief complaint,primary diagnosis,onsite treatment,transfer,psychological crisis intervention and so on.Results The 143 tibetan victims contained 67 fracture cases(4 open fracture,63 closed fracture),5 joint dislocation cases and 3 neural injury cases.62 victims with fracture were treated by Tibetan-Chinese therapy combined with external fixation,5 victims were operated with emergency surgery,6 victims refused to the surgical debridement and suture,and no dead case reported.All patients were given 3 to 11 psychological intervention treatments.As to the aspect of the wounded transferring,48 cases among 54 supposed evacuating victims were transferred to Xinin hospitals,and the other six refused to be transferred and kept staying in the original place for treatment.Conclusion The clinical characteristics of the tibetan victims are outstanding.The medical rescue for disaster in ethnic region should be appropriate for features of disaster areas.Both the individualized remedy and early psychological intervention are regarded as the important measures for improving the general level of earthquake medical rescue in ethnic regions.
Objective To analyze clinical characteristics and treatment experience of 143 tibetan victims of China Yushu earthquake,so as to provide reference for emergency preparation for earthquake disasters.Methods A retrospective study from April 16th to April 22th,2010 was designed.A total of 143 injured Tibetans(74 men,69 women) of the magnitude 7.1 Yushu earthquake were included in this study.Data from victims was collected retrospectively as follows: age,gender,cause of injury,place and time of rescue,chief complaint,primary diagnosis,onsite treatment,transfer,psychological crisis intervention and so on.Results The 143 tibetan victims contained 67 fracture cases(4 open fracture,63 closed fracture),5 joint dislocation cases and 3 neural injury cases.62 victims with fracture were treated by Tibetan-Chinese therapy combined with external fixation,5 victims were operated with emergency surgery,6 victims refused to the surgical debridement and suture,and no dead case reported.All patients were given 3 to 11 psychological intervention treatments.As to the aspect of the wounded transferring,48 cases among 54 supposed evacuating victims were transferred to Xinin hospitals,and the other six refused to be transferred and kept staying in the original place for treatment.Conclusion The clinical characteristics of the tibetan victims are outstanding.The medical rescue for disaster in ethnic region should be appropriate for features of disaster areas.Both the individualized remedy and early psychological intervention are regarded as the important measures for improving the general level of earthquake medical rescue in ethnic regions.
引文
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9 Kuwagata Y,Oda J,Tanaka H,et al.Analysis of 2,702 traumatized patients in the 1995 hanshin-awaji earthquake.J Trauma,1997,43(3):427-432.
10赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查.中国循证医学杂志,2008,8(10):815-819.
2 Laverick S,Kazmi S,Ahktar S,et al.Asian earthquake:report from the rst volunteer british hospital team in pakistan.Emerg Med J,2007,24(8):543-546.
3 Papadopoulos IN,Kanakaris N,Trianta llidis A,et al.Autopsy nd-ings from 111 deaths in the 1999 athens earthquake as a basis for auditing the emergency response.Br J Surg,2004,91(12):1633-1640.
4雷百灵,周云,朱颖,等.汶川地震绵阳极重灾区医疗救援应急指挥纪实.中国循证医学杂志,2008,8(8):581-587.
5冯琦,王东,陈立,等.“5.12”汶川特大地震灾害前沿医院”紧急综合救治区”的建立和管理.中华急诊医学杂志,2008,17(7):684-686.
6卢世璧.汶川地震伤员救治的几点经验.中国矫形外科杂志,2008,16(20):1521-1522.
7谢娟,杜亮,夏天,等.四川大学华西医院1861例汶川地震和死亡伤员伤情与死亡分析.中国循证医学杂志,2008,8(8):591-596.
8 Bhatti SH,Ahmed I,Qureshi NA,et al.Head trauma due to earth-quake october,2005-experience of 300 cases at the combined military hospital rawalpindi.Journal of the College of Physicians and Surgeons--Pakistan:Jcpsp,2008,18(1):22-26.
9 Kuwagata Y,Oda J,Tanaka H,et al.Analysis of 2,702 traumatized patients in the 1995 hanshin-awaji earthquake.J Trauma,1997,43(3):427-432.
10赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查.中国循证医学杂志,2008,8(10):815-819.
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