青海玉树地震转诊伤员26例临床分析
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摘要
目的探讨青海玉树地震伤员伤情特点及其早期救治。方法收集2010年4月16日至5月18日收治的26例地震伤员资料,分析伤情特点和早期救治、积极防治并发症及多学科协同治疗的体会。结果 26例伤员中,年龄15～68岁,平均42.6岁。共有44处损伤。直接砸、压、埋所致多发伤24例(92.3%)。骨折24例(92.3%)。发病部位多在四肢(10例,41.7%),脊柱(3例,12.5%),骨盆(3例,12.5%),和肋、锁骨(8例,33.3%)。术后合并创面感染致感染性休克1例,合并其他伤病包括胸腔积液2例,肺部感染1例,脑震荡1例,完全性截瘫1例,褥疮1例,贫血6例,明显心因性反应6例。转入ICU治疗2例,共实施院内会诊8次,省内专家组会诊4次,卫生部专家组会诊1次。先后有骨科、胸外、急诊、呼吸及心内多学科协助治疗。通过正确处理伤口尽早闭合创面,运用综合措施合理处理骨折,进行肢体术后的早期康复锻炼,积极防治并发症,多学科协同治疗,加强护理,注重心理疏导和亲情关爱,26例伤员全部康复出院。结论地震灾难救援中,救治速度是关键,多学科协同治疗、中西医结合疗法可挽救更多伤员的生命。
Objective To investigate the characteristics of injury condition of the wounded in the earthquake of yushu of qinghai province and the early remedy.Methods The data of the 26 wounded admitted to our hospital between April 16,2010 and May 18,2010 were collected to analyze the injury condition and summarize the experience of early remedy,preventing and treating complications and cooperation of multidisciplinary.Results In the 26 wounded,the ages were 15 to 68 years (mean 42.6 years).There were 44 injuries in all.The patients suffered from multiple trauma caused by direct smashing,pressure and burying were 24 cases (92.3%),and the patients suffered from bone fracture were 24 cases (92.3%).The most common pathogenic sites included the limbs (10 cases,41.7%),the spine (3 cases,12.5%),the pelvis (3 cases,12.5%) and ribs and clavicles (8 cases,33.3%).One case complicated infectious shock caused by infection of injured area post operation,and other concurrent injury included pleural effusion (2 cases),pulmonary infection (1 case),concussion of brain (1 case),complete paraplegia (1 case),bedsore (1 case),anemia (6 cases) and obvious psychogenic reaction (6 cases).Patients transferred to ICU were 2 cases.Consultations in hospital staff,consultasions of specialist group in province and consultation of specialist group of the Health Ministry were 8,4 times and 1 time,respectively.The cooperation of multidisciplinary included departments of orthopedics,thoracic surgery,emergency,respiratory diseases and cardiology.All the wounded recovered and discharged through correct processing wound,closing injured area as soon as possible,reasonable processing bone fracture by integrated measures,early recovery exercise post operation,preventing and treating complications,cooperation of multidisciplinary,strengthening nursing,paying attention to psychological dredge and loving care.Conclusions In the rescue of earthquake disaster,the speed is the key,and the cooperation of multidisciplinary and treating combined therapy of Traditional Chinese and Western medicine might save more lives of the wounded.
Objective To investigate the characteristics of injury condition of the wounded in the earthquake of yushu of qinghai province and the early remedy.Methods The data of the 26 wounded admitted to our hospital between April 16,2010 and May 18,2010 were collected to analyze the injury condition and summarize the experience of early remedy,preventing and treating complications and cooperation of multidisciplinary.Results In the 26 wounded,the ages were 15 to 68 years (mean 42.6 years).There were 44 injuries in all.The patients suffered from multiple trauma caused by direct smashing,pressure and burying were 24 cases (92.3%),and the patients suffered from bone fracture were 24 cases (92.3%).The most common pathogenic sites included the limbs (10 cases,41.7%),the spine (3 cases,12.5%),the pelvis (3 cases,12.5%) and ribs and clavicles (8 cases,33.3%).One case complicated infectious shock caused by infection of injured area post operation,and other concurrent injury included pleural effusion (2 cases),pulmonary infection (1 case),concussion of brain (1 case),complete paraplegia (1 case),bedsore (1 case),anemia (6 cases) and obvious psychogenic reaction (6 cases).Patients transferred to ICU were 2 cases.Consultations in hospital staff,consultasions of specialist group in province and consultation of specialist group of the Health Ministry were 8,4 times and 1 time,respectively.The cooperation of multidisciplinary included departments of orthopedics,thoracic surgery,emergency,respiratory diseases and cardiology.All the wounded recovered and discharged through correct processing wound,closing injured area as soon as possible,reasonable processing bone fracture by integrated measures,early recovery exercise post operation,preventing and treating complications,cooperation of multidisciplinary,strengthening nursing,paying attention to psychological dredge and loving care.Conclusions In the rescue of earthquake disaster,the speed is the key,and the cooperation of multidisciplinary and treating combined therapy of Traditional Chinese and Western medicine might save more lives of the wounded.
引文
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[2]Schwartz D,Goldberg A,Ashkenasi I,et al.Prehospital care of tsu-nami victims in Thailand:description and analysis[J].Prehosp Dis-aster Med,2006,21(3):204-210.
[3]李磊琼.地震后儿童心理干预与转变过程探索[J].中国健康心理学杂志,2007,15(6):526-528.
[4]郭薇.心理危机干预概论[M].成都:四川科学技术出版社,2007:57-62.
[5]姚元章,张连阳.急救绿色通道在严重创伤救治早期救治中的作用[J].中华创伤杂志,2008,24(4):268-270.
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