四川地震疾病谱对医学救援的意义
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摘要
目的探讨地震灾害的疾病谱对指导医学救援的意义。方法按WHO灾难医学救援疾病分类法分为五大类疾病,依据四川汶川地震医院救治中的数据分析灾后1～14d疾病谱及其变化规律。结果灾后7d内,以外伤/伤口类疾病为主(74.1%～98.6%)。7d后,其他类内科疾病明显上升(44.3%～75.0%),且急性上呼吸道感染疾病发病率较高,急性肠炎13例,未有出血性肠炎病例。骨折中以下肢骨折发生率最高(31.1%),颅骨骨折发生率为9.3%。38例死亡病例中,29例有单纯或合并颅骨骨折。结论①灾后7d内,以外伤/伤口类疾病为主,死亡主要集中于此期,故抢救生命是首要目标。②灾后7d后,各类疾病均有较高发生率,此期需要大量医疗资源以降低患者致残率,治疗上呼吸道和肠道感染,防治传染病暴发流行。③单纯或合并颅骨骨折的死亡率高,此类患者需要早期分检和重点救治。
Objective To investigate the significance of the distribution of diseases after earthquake disaster.Method According to the classification of diseases set by World Health Organization,there were five diseases including injuries/wounds,acute upper respiratory tract infection,acute hemorrhagic enteritis,acute enteritis and other diseases of internal medicine.We analyzed the distribution of disease and its regularity by the data in the hospital 1～14 days after the earthquake.Results Injuries/wounds mainly occurred within 7 days after earthquake.The incidences were 74.1% to 98.6%.Other diseases usually appeared one week later with the incidence of 44.3% to 75%.The incidence of acute upper respiratory tract infection reached considerably high rate one week after disaster.Whereas 13 patients with acute enteritis was found,the rate of acute hemorrhagic enteritis was 0.The rate of the fracture of lower extremity was highest in all fractures with the incidence of 31.1%.29 patients were diagnosed as simple and compound skull fracture in 38 died patients.Conclusion ① Injuries/wound are the main disease and major lethal factor on 7th day after disaster,so it is the most important to save lives.② The incidences of various kinds of diseases increase and more medical aids are needed in order to treat the upper respiratory tract infection and to lower the disable rate,and to prevent the prevalence of epidemic diseases during 7～14 days.③In view of high mortality of skull fracture,early selection and more intensive care treatment are important.
Objective To investigate the significance of the distribution of diseases after earthquake disaster.Method According to the classification of diseases set by World Health Organization,there were five diseases including injuries/wounds,acute upper respiratory tract infection,acute hemorrhagic enteritis,acute enteritis and other diseases of internal medicine.We analyzed the distribution of disease and its regularity by the data in the hospital 1～14 days after the earthquake.Results Injuries/wounds mainly occurred within 7 days after earthquake.The incidences were 74.1% to 98.6%.Other diseases usually appeared one week later with the incidence of 44.3% to 75%.The incidence of acute upper respiratory tract infection reached considerably high rate one week after disaster.Whereas 13 patients with acute enteritis was found,the rate of acute hemorrhagic enteritis was 0.The rate of the fracture of lower extremity was highest in all fractures with the incidence of 31.1%.29 patients were diagnosed as simple and compound skull fracture in 38 died patients.Conclusion ① Injuries/wound are the main disease and major lethal factor on 7th day after disaster,so it is the most important to save lives.② The incidences of various kinds of diseases increase and more medical aids are needed in order to treat the upper respiratory tract infection and to lower the disable rate,and to prevent the prevalence of epidemic diseases during 7～14 days.③In view of high mortality of skull fracture,early selection and more intensive care treatment are important.
引文
1徐家相.地震灾害的紧急医疗救援[J].中华急诊医学杂志,2005,14(7):557-558.
2Roy N,Shah H,Patel V,et al.Surgica1and psychosocial outcomes in the rural injured--a follow—up study of the2001earthquake vic-tims[J].Injury,2005,36(8):927.
3刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学杂志,2006,15(12):1063-1066.
4彭碧波,仝青英,杨造成.印尼日惹地震救援中流动医院疾病谱分析[J].武警医学,2006,17(10):785-786.
2Roy N,Shah H,Patel V,et al.Surgica1and psychosocial outcomes in the rural injured--a follow—up study of the2001earthquake vic-tims[J].Injury,2005,36(8):927.
3刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学杂志,2006,15(12):1063-1066.
4彭碧波,仝青英,杨造成.印尼日惹地震救援中流动医院疾病谱分析[J].武警医学,2006,17(10):785-786.
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