芦山地震和汶川地震中儿童伤员的临床特征比较及急救经验
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摘要
目的为了更为全面地认识地震中儿童伤员的临床特征和救治状况,总结地震中儿童伤员救治经验。方法收集四川大学华西医院2013年芦山地震和2008年汶川地震中收治的儿童伤员的临床信息,分析比较两次地震中儿童伤员的有关数据。结果截至2013年4月30日,该院共收治了芦山地震14岁以下伤员34人。与汶川地震的数据比较,芦山地震儿童伤员的年龄更小(P<0.01),地震到入院的平均时间更短(P<0.01)。芦山地震中,67.6%的伤员有不同程度的肢体骨折,儿童颅脑损伤比例明显高于汶川地震(29.4%vs 9.5%,P<0.05)。芦山地震收治患儿没有截肢,没有死亡,13位极危重症和重症儿童伤员均顺利进入康复阶段。结论芦山地震儿童伤员中重症患儿及颅脑损伤患儿比例较高,但治疗转归较好,这可能与及时的现场救援和转运及多部门、多级医疗机构、多学科的通力合作有关。
Objective To get a more comprehensive understanding of the clinical characteristics of pediatric victims in earthquake and to summarize the experience of medical rescue.Methods The clinical information was collected from the pediatric victims who were admitted to West China Hospital,Sichuan University following the Lushan earthquake in 2013 and Wenchuan earthquake in 2008.The clinical data were compared between the pediatric victims in the two earthquakes.Results Thirty-four children under 14 years of age,who were injured in the Lushan earthquake,were admitted to the West China Hospital before April 30,2013.Compared with the data in the Wenchuan earthquake,the mean age of the pediatric victims in the Lushan earthquake was significantly lower(P<0.01),and the mean time from earthquake to hospitalization was significantly shorter(P<0.01).In the Lushan earthquake,67.6% of the injured children had variable limb fractures;traumatic brain injury was found in 29.4% of hospitalized children,versus 9.5% in the Wenchuan earthquake(P<0.05).Among the 34 children,no amputation and death occurred,and all the 13 severe cases started to recover.Conclusions There were higher proportions of severely injured children and children with traumatic brain injury in the Lushan earthquake than in the Wenchuan earthquake.But these cases recovered well,which was possibly due to timely on-site rescue and transfer and multi-sector,multi-institution,and multidisciplinary cooperation.
Objective To get a more comprehensive understanding of the clinical characteristics of pediatric victims in earthquake and to summarize the experience of medical rescue.Methods The clinical information was collected from the pediatric victims who were admitted to West China Hospital,Sichuan University following the Lushan earthquake in 2013 and Wenchuan earthquake in 2008.The clinical data were compared between the pediatric victims in the two earthquakes.Results Thirty-four children under 14 years of age,who were injured in the Lushan earthquake,were admitted to the West China Hospital before April 30,2013.Compared with the data in the Wenchuan earthquake,the mean age of the pediatric victims in the Lushan earthquake was significantly lower(P<0.01),and the mean time from earthquake to hospitalization was significantly shorter(P<0.01).In the Lushan earthquake,67.6% of the injured children had variable limb fractures;traumatic brain injury was found in 29.4% of hospitalized children,versus 9.5% in the Wenchuan earthquake(P<0.05).Among the 34 children,no amputation and death occurred,and all the 13 severe cases started to recover.Conclusions There were higher proportions of severely injured children and children with traumatic brain injury in the Lushan earthquake than in the Wenchuan earthquake.But these cases recovered well,which was possibly due to timely on-site rescue and transfer and multi-sector,multi-institution,and multidisciplinary cooperation.
引文
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[7]Bulut M,Fedakar R,Akkose S,Akgoz S,Ozguc H,Tokyay R,et al.Medical experience of a university hospital in Turkey afterthe 1999 Marmara earthquake[J].Emerg Med J,2005,22(7):494-498.
[8]Jia L,Li GP,You C,Li H,Huang SQ,Yang CH,et al.The ep-idemiology and clinical management of craniocerebral injury causedby the Sichuan earthquake[J].Neurol India,2010,58(1):85-89.
[9]Xiang B,Cheng W,Liu J,Huang L,Li Y,Liu L.Triage of ped-iatric injuries after the 2008 Wen-Chuan earthquake in China[J].J Pediatr Surg,2009,44(12):2273-2277.
[10]Li Q,Yang CH,Xu JG,Chen J,You C.Cross-sectional study ofcraniocerebral trauma in a tertiary hospital after 2008 Sichuanearthquake:brief reportof 242 cases and experiences from WestChina Hospital[J].J Trauma,2011,70(6):E108-E112.
[11]Starr AJ,Hunt JL,Chason DP,Reinert CM,Walker J.Treatmentof femur fracture with associated head injury[J].J Orthop Trau-ma,1998,12(1):38-45.
[12]余秀君,何成奇,丁明甫,杜春萍,王凤英.华西医院地震伤员康复医疗的应急体系[J].中国康复医学杂志,2008,23(7):585-586.
[13]郑毅.汶川地震对儿童心理的影响与心理救助[J].中国循证儿科杂志,2008,3(增刊):71-72.
[2]石应康,郑尚维.区域性国家级医院在汶川地震医疗救援中的战略支撑作用[J].中国循证医学杂志,2008,8(6):380-382.
[3]谢娟,杜亮,夏天,王觅也,刁骧,李幼平.四川大学华西医院1861例汶川地震住院和死亡伤员伤情与死因分析[J].中国循证医学杂志,2008,8(8):591-596.
[4]Narci A,Solak O,Turhan-Haktanir N,Ayiek A,Demir Y,ElaY,et al.The prognostic importance of trauma scoring systems inpediatric patients[J].Pediatr Surg Int,2009,25(1):25-30.
[5]孟新科.急危重症评分—评价、预测、处理[M].第一版.北京:人民卫生出版社,2008:58-81.
[6]唐甫斌,浦金辉,张璧,李丽英,吴恒义.地震伤员的处理原则[J].创伤外科杂志,2007,9(3):210.
[7]Bulut M,Fedakar R,Akkose S,Akgoz S,Ozguc H,Tokyay R,et al.Medical experience of a university hospital in Turkey afterthe 1999 Marmara earthquake[J].Emerg Med J,2005,22(7):494-498.
[8]Jia L,Li GP,You C,Li H,Huang SQ,Yang CH,et al.The ep-idemiology and clinical management of craniocerebral injury causedby the Sichuan earthquake[J].Neurol India,2010,58(1):85-89.
[9]Xiang B,Cheng W,Liu J,Huang L,Li Y,Liu L.Triage of ped-iatric injuries after the 2008 Wen-Chuan earthquake in China[J].J Pediatr Surg,2009,44(12):2273-2277.
[10]Li Q,Yang CH,Xu JG,Chen J,You C.Cross-sectional study ofcraniocerebral trauma in a tertiary hospital after 2008 Sichuanearthquake:brief reportof 242 cases and experiences from WestChina Hospital[J].J Trauma,2011,70(6):E108-E112.
[11]Starr AJ,Hunt JL,Chason DP,Reinert CM,Walker J.Treatmentof femur fracture with associated head injury[J].J Orthop Trau-ma,1998,12(1):38-45.
[12]余秀君,何成奇,丁明甫,杜春萍,王凤英.华西医院地震伤员康复医疗的应急体系[J].中国康复医学杂志,2008,23(7):585-586.
[13]郑毅.汶川地震对儿童心理的影响与心理救助[J].中国循证儿科杂志,2008,3(增刊):71-72.
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