汶川特大地震医学救援行动及战略思考
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摘要
目的总结汶川特大地震医学救援的做法与经验,提高应对重大灾害的医学救援综合能力。方法对汶川特大地震伤亡及医学救援情况进行回顾性调查与描述性分析,结合作者的抗震救灾实践,形成重大灾害医学救援的战略思考。结果汶川特大地震伤亡时间分布以2周为界,分为增长期和稳定期;遇难者主要分布在四川省的北川、绵竹、什邡、都江堰、青川、汶川、彭州7个重灾区,占全部地震灾区遇难人数的72.62%。本次抗震救灾医学救援,从全国32个省(区、市)调派10 630名医疗、防疫等专业人员赶赴灾区。累计救治伤病员200余万名。全国20个省(区、市)的367所军地医院共收治灾区后送伤员10 048名,在地震重灾区开展了分区域或分专项的防疫工作,实现了卫生防疫工作的全覆盖,保证了伤病群众得到及时救治以及灾区大灾之后无大疫。结论应完善国家应急医学救援反应体系,建设国家应急医学救援专业力量,注重医学救援功能模块建设,加强灾害医学学科及人才建设,加速国家应急医学救援信息化建设,优化国家应急医学救援指挥机制,不断提升应对重大灾害的医学救援能力。
Objective To summarize the experiences of medical rescue in Wenchuan Earthquake and enhance the comprehensive competence of medical rescue in coping with heavy disaster.Methods By retrospectively and descriptively analyzing the data related to the casualties and the action of medical rescue in Wenchuan Earthquake from the macro level,combining with the author's experiences in the rescue work,the deep ponderation on the strategy of medical rescue in coping with heavy disaster was formed.Results The time distribution of the casualty could be divided into rising period and steady period by the time two weeks after Wenchuan Earthquake,and the casualties were mainly from 7 seriously destroyed areas(including Beichuan,Mianzhu,Shifang,Dujiangyan,Qingchuan,Wenchuan,Pengzhou),accounting for about 72.62% of all casualties.The medical teams rescued over 2 000 000 victims totally,among them 10 048 victims were evacuated from the distressed areas and well treated in 367 hospitals distributed in 20 provinces.Anti-epidemic measures were then carried out in the serious earthquake areas regionally and subject-specially,ensuring that the urgent medical aid was paid to all the injured people and no epidemics outbreak over the disaster areas after the earthquake.Conclusions Great efforts should be made to enhance the ability of medical rescue,such as the establishment of quick responding medical system;development of national medical rescue teams;accelerative construction of different medical rescue function modules;optimization of the national emergent medical rescue command system;reinforcement of the scientific research on disaster medicine and improvement of the national information network of medical rescue in emergency.
Objective To summarize the experiences of medical rescue in Wenchuan Earthquake and enhance the comprehensive competence of medical rescue in coping with heavy disaster.Methods By retrospectively and descriptively analyzing the data related to the casualties and the action of medical rescue in Wenchuan Earthquake from the macro level,combining with the author's experiences in the rescue work,the deep ponderation on the strategy of medical rescue in coping with heavy disaster was formed.Results The time distribution of the casualty could be divided into rising period and steady period by the time two weeks after Wenchuan Earthquake,and the casualties were mainly from 7 seriously destroyed areas(including Beichuan,Mianzhu,Shifang,Dujiangyan,Qingchuan,Wenchuan,Pengzhou),accounting for about 72.62% of all casualties.The medical teams rescued over 2 000 000 victims totally,among them 10 048 victims were evacuated from the distressed areas and well treated in 367 hospitals distributed in 20 provinces.Anti-epidemic measures were then carried out in the serious earthquake areas regionally and subject-specially,ensuring that the urgent medical aid was paid to all the injured people and no epidemics outbreak over the disaster areas after the earthquake.Conclusions Great efforts should be made to enhance the ability of medical rescue,such as the establishment of quick responding medical system;development of national medical rescue teams;accelerative construction of different medical rescue function modules;optimization of the national emergent medical rescue command system;reinforcement of the scientific research on disaster medicine and improvement of the national information network of medical rescue in emergency.
引文
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[13]Saghafinia M,Araghizade H,Nafissi N,et al.Treatment management in disaster:a reviewof the Bamearthquake experience.Prehosp Disaster Med,2007,22(6):517
[14]李卫民.国家应急救援运行体系的构建.中国民用航空,2008,90(6):30
[15]包元晖,蒲海龙.发挥专业救援作用,加强装备与技术保障.中国个体防护装备,2008,(3):8
[16]盛志勇.军队医院战创伤学科建设的思考.解放军医学杂志,2008,33(12):1399
[17]Delooz H,Debacker M,Moens G,et al.European survey ontraining objectivesin disaster medicine.Eur J Emerg Med,2007,14(1):25
[18]Alexander AJ,Bandiera GW,Mazurik L.A multiphase disaster training exercise for emergency medicine residents:opportunity knocks.Acad EmergMed,2005,12(5):404
[19]李宗浩,金辉.论中国救援医学的创立及其在国家突发公共事件中的地位.中华医学杂志,2005,85(22):1519
[20]张雁灵.发挥军医大学优势作用,全面提高军队卫勤保障能力.第二军医大学学报,2008,29(7):713
[21]李兆申.现代军事应激与军人心理健康.解放军医学杂志,2007,32(3):179
[22]De Boer J.Order in chaos:modeling medical management in disasters.Eur J Emerg Med,1999,6(2):141
[23]Domres B,Schauwecker HH,Rohrmann K.The German approachto emergency/disaster management.Med Arh,2000,54(4):201
[2]Schultz CH,Koenig KL,Noji EK.A medical disaster responsetoreducei mmediate mortality after anearthquake.NEngl J Med,1996,334(26):438
[3]何忠杰,马俊勋.论战创伤急救的时效性.解放军医学杂志,2005,30(7):566
[4]何忠杰.创伤急救的新概念——白金10分钟.解放军医学杂志,2004,29(11):1009
[5]卢世璧.汶川地震伤员救治分级处理的重要性.解放军医学杂志,2008,33(8):919
[6]Sever MS,Vanholder R,Lameire N.Management of crush-relatedinjuries after disasters.NEngl J Med,2006,354(23):1052
[7]卢世璧.汶川特大地震伤员救治的几点经验.中国矫形外科杂志,2008,16(20):1521
[8]席梅,侯建盛,刘爱兵.国际地震救援行动中的医疗力量配置分析.灾害学,2007,22(4):138
[9]刘纪宁,王羽,刘云兵,等.四川地震疾病谱对医学救援的意义.中国急救医学,2008,28(6):513
[10]赵琦,赵根明,谢昀,等.突发公共卫生事件应急体系建设内涵的定性研究.中国预防医学杂志,2008,9(6):452
[11]WHO.Revisedinternational regulation.Fifty-eight world health assembly.Geneva:WHO,2005
[12]张雁灵.关于重大灾害医疗卫生应急救援工作的思考与建议.解放军医院管理杂志,2008,15(7):601
[13]Saghafinia M,Araghizade H,Nafissi N,et al.Treatment management in disaster:a reviewof the Bamearthquake experience.Prehosp Disaster Med,2007,22(6):517
[14]李卫民.国家应急救援运行体系的构建.中国民用航空,2008,90(6):30
[15]包元晖,蒲海龙.发挥专业救援作用,加强装备与技术保障.中国个体防护装备,2008,(3):8
[16]盛志勇.军队医院战创伤学科建设的思考.解放军医学杂志,2008,33(12):1399
[17]Delooz H,Debacker M,Moens G,et al.European survey ontraining objectivesin disaster medicine.Eur J Emerg Med,2007,14(1):25
[18]Alexander AJ,Bandiera GW,Mazurik L.A multiphase disaster training exercise for emergency medicine residents:opportunity knocks.Acad EmergMed,2005,12(5):404
[19]李宗浩,金辉.论中国救援医学的创立及其在国家突发公共事件中的地位.中华医学杂志,2005,85(22):1519
[20]张雁灵.发挥军医大学优势作用,全面提高军队卫勤保障能力.第二军医大学学报,2008,29(7):713
[21]李兆申.现代军事应激与军人心理健康.解放军医学杂志,2007,32(3):179
[22]De Boer J.Order in chaos:modeling medical management in disasters.Eur J Emerg Med,1999,6(2):141
[23]Domres B,Schauwecker HH,Rohrmann K.The German approachto emergency/disaster management.Med Arh,2000,54(4):201
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