826例汶川地震住院伤员伤情特点及救治分析  

Analysis on injury characteristics and treatment of the hospitalized patients attributable to 2008 Wenchuan earthquake in China： a report of 826 cases

作　　者：刘国栋[1] 王普杰 王苏星[1] 邱俊[2] 张岫竹[2] 李阳[2] 杨志焕[2] 许涛[4] 周继红[2] 肖庆 王正国[2] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所八室,重庆400042 [2]第三军医大学附属大坪医院野战外科研究所四室,重庆400042 [3]解放军第五二0医院 [4]同济大学附属东方医院

出　　处：《中华创伤杂志》2009年第5期446-450,共5页Chinese Journal of Trauma

基　　金：国家高技术研究发展计划（863计划）资助项目（2008AA022501）;重庆市科技攻关计划项目资助（CSTC,2008AA0011）.致谢 感谢四川大学华西医院、德阳市第一人民医院和德阳市第二人民医院在数据收集过程中给予的帮助

摘　　要：目的分析汶川地震住院伤员的伤情特点及救治，为类似自然灾害所致伤员的救治提供参考。方法利用《创伤数据库系统》V3．0收集录入的四川大学华西医院和德阳市第一和第二人民医院收治的地震伤员资料，对伤员一般情况、伤情特点和治疗措施进行分析比较。结果共收集资料较为完整、符合要求的伤员826例，其中男410例，女416例；年龄1～102岁，平均45．8岁。其中31～60岁伤员占总数的50．2％。有职业记录的477例中，农民占43．8％（209／477），工人占15．7％（75／477），在校学生占14．1％（67／477）。钝器伤（53．2％）、挤压／掩埋（22．5％）和跌倒／坠落（15．0％）为前3位致伤原因。德阳市两家医院收治的伤员入院时间主要集中在地震后4d内，占92．1％；华西医院收治的伤员入院时间主要集中在震后3～9d（81．7％）。骨科伤员占伤员总数的59．2％。伤员的AIS主要集中在1—3分的区域。严重多发伤（ISS〉16分）发生率为8．2％。入院后接受内固定术120例（34．1％），清创缝合术103例（29．3％）及外固定术55例（15．6％）。肢体离断术22例（6．3％），颅内手术仅2例（0．6％）。结论地震导致的建筑物倒塌是主要致伤机制，伤员以骨伤较多。损伤多在AIS1～3分范围，严重多发伤较少。伤员接受专业救治时间普遍较晚，伤员后送分流较迟，提示对特大自然灾害所致伤员的早期救治和及时高效后送救治的能力亟待加强。Objective To analyze injury characteristics and treatment of hospitalized patients wounded in Wenchuan earthquake so as to provide references for medical rescue in disasters. Methods The study involved data of seismic patients from Trauma Database System Version 3.0 that collected clinical data of seismic patients admitted into West China Hospital of Sichuan University, Chengdu, and First and Second Hospitals of Deyang City. Trauma Database System Version 3.0 was developed by Research Institute for Traffic Medicine of PLA, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing. A comparative analysis was done on patient distribution, injury severity and medical treatment. Results There were 826 qualified patients including 410 males and 416 females （at age range of 1-102 years, mean 45.8 years）. Of all, the patients at age of 31-60 years accounted for 50. 2%. The patients were mainly peasants （43.8%, 208/477）, workers （15. 7%, 75/477） and students （14.1%, 67/477）. Blunt injury （53.2%）, crush/bury injury （22.5%） andslip/fall injury were three main causes for injury. The patients for 92.1% were admitted into two hospitals of the City of Deyang within four days after earthquake, while 81.7% of patients were admitted into West China Hospital in Chengdu at days 3-9 after earthquake. Patients with bone injuries accounted for 75.3%. The patients had abbreviated injury score （AIS） for mainly 1-3 points, with incidence rate of severe multiple trauma （ISS 〉 16 points） of 8.2%. Internal fixation was done in 120 patients （34.1% ）, debridement and suturing in 103 （29.3%）, external fixation in 55 （ 15.6% ）, extremity amputation in 22 （6.3%） and intracerebral surgery in 2 （0.6%）. Conclusions The injuries are mainly induced by collapse of buildings during earthquake. Bone injuries are predominant injury type, with AIS of mainly 1-3 points and few severe multiple trauma. The results show that the patients receive late special treatment and

关 键 词：自然灾害 创伤和损伤 数据收集 流行病学研究 

分 类 号：R64[医药卫生—外科学]