一线三甲医院汶川地震420例骨折住院伤员分类救治情况分析
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摘要
目的回顾性分析德阳市人民医院骨科在汶川地震后7天内收治的420例骨折伤员的救治情况,为今后重大灾难事件中的骨折伤员救治提供参考。方法收集德阳市人民医院骨科自2008年5月12日～18日收治的地震致骨折伤员的详细资料,分析伤员的基本情况和伤后救治效果。资料录入采用EXCEL软件,统计分析采用SPSS13.0软件。结果我院共收治462例住院骨折伤员,其中42例基本信息缺失,最终纳入分析420例。纳入病例中,男176例(41.9%),女244例(58.1%);中位年龄43(27,61)岁。震后前3天收治328例(78.1%),震后第4～7天收治92例(21.9%)。伤员主要来自绵竹、什邡和广汉市。入院诊断前3位骨折部位依次为胫骨(18.8%)、腓骨(16.6%)和股骨(14.9%)。分类救治方法前3位依次为闭合性骨折患者复位后行小夹板或石膏、牵引外固定(301例),闭合复位不佳行切开复位内固定或外固定支架固定(85例),开放性骨折行清创缝合及石膏外固定(78例)。结论总结汶川地震中骨折伤员的分类救治经验,建立重大灾害骨折伤紧急诊治机制,有针对性地储备治疗物资和安排救治人员,是今后发生重大地震灾害时保证伤员得到有效治疗的重要措施。
Objective To retrospectively analyze the 420 fractured inpatients in the People's Hospital of Deyang city seven days after the Wenchuan earthquake,so as to provide reference for the improvement of emergency plans earthquakes and the subsequent treatment of fracture patients.Methods The analysis was based on the data provided by the Department of Orthopedics of the Hospital up until July 18,2008.The software Microsoft EXCEL was used for data input,and SPSS 13.0 was used for statistical analysis.Results Up to July 18 420 cases from the disaster area have been treated in the department of orthopedics,including 176 men(41.9%)and 244 women(58.1%),the age was from 1 to 102 years and a median age of 43 years(2 761)among the inpatients.Most patients(328 cases)were sent to the hospital within the first three days after the quake(78.1%),and the number of inpatients were 92 4-7 days after the quake.The wounded were mainly from Mianzhu,Shifang,and Guanghan.The admission fracture diagnoses were tibial fractures(18.8%),fibular fractures(16.6%),and femoral fractures(14.9%).The major treatments were splinting,plaster fixation,or traction for closed fractures(301 cases),internal fixation or external fixation for malreduction(85 cases),and debridement suture and plaster fixation for open fractures(78 cases).Conclusion It is a vital to develop an emergent plan for fracture patients after an earthquake disaster and to strengthen the reserve of medical supplies,personnel training,and individual therapy.
Objective To retrospectively analyze the 420 fractured inpatients in the People's Hospital of Deyang city seven days after the Wenchuan earthquake,so as to provide reference for the improvement of emergency plans earthquakes and the subsequent treatment of fracture patients.Methods The analysis was based on the data provided by the Department of Orthopedics of the Hospital up until July 18,2008.The software Microsoft EXCEL was used for data input,and SPSS 13.0 was used for statistical analysis.Results Up to July 18 420 cases from the disaster area have been treated in the department of orthopedics,including 176 men(41.9%)and 244 women(58.1%),the age was from 1 to 102 years and a median age of 43 years(2 761)among the inpatients.Most patients(328 cases)were sent to the hospital within the first three days after the quake(78.1%),and the number of inpatients were 92 4-7 days after the quake.The wounded were mainly from Mianzhu,Shifang,and Guanghan.The admission fracture diagnoses were tibial fractures(18.8%),fibular fractures(16.6%),and femoral fractures(14.9%).The major treatments were splinting,plaster fixation,or traction for closed fractures(301 cases),internal fixation or external fixation for malreduction(85 cases),and debridement suture and plaster fixation for open fractures(78 cases).Conclusion It is a vital to develop an emergent plan for fracture patients after an earthquake disaster and to strengthen the reserve of medical supplies,personnel training,and individual therapy.
引文
1Peek-Asa C,Ramirez M,Seligson H,et al.Seismic,structural,and individual factors associated with earthquake related injury.Injury Prevention(Inj Prev),2003,9:62-66.
2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.
3谭大华,吴陈,马红,等.汶川地震后德阳极重灾区预防性消毒工作调查分析.中国循证医学杂志,2008,8(8):610-615.
4薛力,陈敏,尹代红,等.成都市第三人民医院563例汶川地震伤员救治分析.中国循证医学杂志,2008,8(8):597-601.
5Kazzi AA,Langdorf MI,Handly N,et al.Earthquake epidemiology:the1994Los Angeles Earthquake emergency department experience at a community hospital.Prehosp Disaster Med,2000,15(1):12-19.
6孙志刚,李宏立.地震伤员分类的方法和原则.灾害学,2001,16(001):61-64.
7Bozkurt M,Ocguder A,Turktas U,et al.The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in2005.Injury,2007,38(3):290-297.
8Douglas KS,William PC.External fixation of high energy upper extremity injuries.J Orthop Trauma,1990,4(1):7-18.
2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.
3谭大华,吴陈,马红,等.汶川地震后德阳极重灾区预防性消毒工作调查分析.中国循证医学杂志,2008,8(8):610-615.
4薛力,陈敏,尹代红,等.成都市第三人民医院563例汶川地震伤员救治分析.中国循证医学杂志,2008,8(8):597-601.
5Kazzi AA,Langdorf MI,Handly N,et al.Earthquake epidemiology:the1994Los Angeles Earthquake emergency department experience at a community hospital.Prehosp Disaster Med,2000,15(1):12-19.
6孙志刚,李宏立.地震伤员分类的方法和原则.灾害学,2001,16(001):61-64.
7Bozkurt M,Ocguder A,Turktas U,et al.The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in2005.Injury,2007,38(3):290-297.
8Douglas KS,William PC.External fixation of high energy upper extremity injuries.J Orthop Trauma,1990,4(1):7-18.
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