成都市第三人民医院563例汶川地震伤员救治分析
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摘要
目的回顾性分析汶川地震成都市第三人民医院医疗救援总体情况,为今后完善和健全地震灾害应急预案机制提供决策参考。方法从医院信息处、病案室、急诊科、骨科及其它相关临床科室系统收集震后至7月12日8时止收治地震伤员的相关资料,分析伤员基本情况和医院总体救治情况。资料录入采用EXCEL表格,统计分析采用SPSS11.5软件。结果截至7月12日,共收治563例地震伤员,包括门诊伤员249例,住院伤员314例。其中男性287例,女性276例;中位年龄门诊伤员42(28,57)岁,住院伤员46(33,65)岁,住院伤员年龄明显大于门诊伤员(P=0.003)。门诊伤员集中在震后前3天(占73.50%),而住院伤员震后前3天不足50%。伤员主要来自都江堰市、阿坝州和彭州市;伤情分类前3位为骨科(69.3%)、神经外科(15.6%)、普外科(3.7%)。总医疗费用最高的3个科室依次为骨科、ICU和神经外科;而人均中位费用最高的3个科室分别为ICU、神经外科和肾内科。救治过程中共死亡9例,其中院前死亡5例,住院死亡4例;含颅脑损伤8例,挤压综合征1例。结论总结汶川地震医疗救援经验,建立我国地震灾害医疗救援应急预案,有针对性地加强硬件建设、物资储备和人员培训,科学现场分拣与加强信息平台建设,是提高今后地震医疗救援整体水平的重要措施。
Objective To analyze retrospectively the overall situation of medical rescue in the Third People's Hospital of Chengdu after the Wenchuan earthquake,so as to provide references for the emergency preparedness for the disaster of earthquake.Methods The analysis was based on the data provided by the Department of Information,the Medical Record Library,the Department of Emergency,the Department of Orthopaedics and other related departments of the Hospital up to 8 a.m.of July 12.The software of Microsoft EXCEL was used for data input,and SPSS 11.5 was used for statistical analysis.Results Up to July 12,563 cases from the disaster area had been treated in the hospital,of whom 249 were admitted into the outpatient department and 314 into the inpatient department,including 287 men and 276 women,with a median age of 42 years(28,57) in the outpatient department and a median age of 46 years(33,65) in the inpatient department.The inpatients' age was older than the outpatients's(P=0.003).Most outpatients were sent to the hospital within the first 3 days after the quake(73.50%),while less than half of the inpatients were sent to the hospital during this period of time.The wounded were mainly from Dujiangyan,Aba Prefecture and Pengzhou,which was correlated with the transportation distance,the casualty and the condition of the local hospitals.The wounded were mainly admitted into the Departments of Orthopaedics(69.3%),Neurosurgery(15.6%) and General Surgery(3.7%).The total cost in the Department of Orthopaedics was the highest,followed by the Intensive Care Unit(ICU) and the Department of Neurosurgery.However,the median cost in the ICU was the highest,followed by the Department of Neurosurgery and the Department of Nephrology.Only 9 out of the 563 patients died,including 5 outpatients and 4 inpatients,of whom 8 deaths were due to craniocerebral injury and 1 died of crush syndrome.Conclusion Based on the data,it is of vital importance to develop an emergent plan for the medical rescue after an earthquake disaster,and to strengthen the reserve of medical supplies,personnel training,scientific field triage as well as the construction of information platforms.
Objective To analyze retrospectively the overall situation of medical rescue in the Third People's Hospital of Chengdu after the Wenchuan earthquake,so as to provide references for the emergency preparedness for the disaster of earthquake.Methods The analysis was based on the data provided by the Department of Information,the Medical Record Library,the Department of Emergency,the Department of Orthopaedics and other related departments of the Hospital up to 8 a.m.of July 12.The software of Microsoft EXCEL was used for data input,and SPSS 11.5 was used for statistical analysis.Results Up to July 12,563 cases from the disaster area had been treated in the hospital,of whom 249 were admitted into the outpatient department and 314 into the inpatient department,including 287 men and 276 women,with a median age of 42 years(28,57) in the outpatient department and a median age of 46 years(33,65) in the inpatient department.The inpatients' age was older than the outpatients's(P=0.003).Most outpatients were sent to the hospital within the first 3 days after the quake(73.50%),while less than half of the inpatients were sent to the hospital during this period of time.The wounded were mainly from Dujiangyan,Aba Prefecture and Pengzhou,which was correlated with the transportation distance,the casualty and the condition of the local hospitals.The wounded were mainly admitted into the Departments of Orthopaedics(69.3%),Neurosurgery(15.6%) and General Surgery(3.7%).The total cost in the Department of Orthopaedics was the highest,followed by the Intensive Care Unit(ICU) and the Department of Neurosurgery.However,the median cost in the ICU was the highest,followed by the Department of Neurosurgery and the Department of Nephrology.Only 9 out of the 563 patients died,including 5 outpatients and 4 inpatients,of whom 8 deaths were due to craniocerebral injury and 1 died of crush syndrome.Conclusion Based on the data,it is of vital importance to develop an emergent plan for the medical rescue after an earthquake disaster,and to strengthen the reserve of medical supplies,personnel training,scientific field triage as well as the construction of information platforms.
引文
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6邹锟,刘关键,李幼平,等.地震伤亡危险因素的系统评价.中国循证医学杂志,2008,8(7):477-482.
2唐甫斌,浦金辉,张璧,等.地震伤员的处理原则.创伤外科杂志,2007,9(3):210.
3Bulut M,Fedakar R,Akkose S,et al.Medical experience of a university hospital in Turkey after the1999Marmara earthquake.Emerg Med J,2005,22:494-498.
4Peek-Asa C,Kraus JF,Bourque LB,et al.Fatal and hospitalized injuries resulting from the1994Northridge earthquake.International Journal of Epidemiology,1998,27:459-465.
5王凌,李静,李幼平,等.大规模伤亡事件伤员分类的系统评价.中国循证医学杂志,2008,8(7):469-476.
6邹锟,刘关键,李幼平,等.地震伤亡危险因素的系统评价.中国循证医学杂志,2008,8(7):477-482.
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