狭窄空间事故的特点及医学应急救援策略  

Characteristics of the confined space accident and its medical rescue strategy

作　　者：岳茂兴[1] 夏锡仪[2] 李瑛[2] 卞晓星[2] 郑琦涵[2] 尹进南[2] 赵晓成[2] 蔡爱敏[2] 

机构地区：[1]解放军第三○六医院特种医学中心,北京100101 [2]江苏大学附属武进医院急诊科,常州213002

出　　处：《中国危重病急救医学》2012年第11期655-657,共3页Chinese Critical Care Medicine

基　　金：江苏省医药卫生重大课题（Z201013）;江苏省常州市社会发展科技计划项目（CS2008213）

摘　　要：目的探讨狭窄空间事故的特点及医学应急救援策略。方法回顾性分析2009年6月至2012年7月参加5起狭窄空间事故现场医学应急救援的情况，分析36例患者的救治结果。结果5起狭窄空间事故中4起因建筑物坍塌造成29例身处狭窄空间中，1起因某地通天塔里炼铁炉损坏，造成7人被困狭窄空间，致使煤气和硫化氢严重中毒。共致伤36例，被救出时间最短1．5h，最长达10．5h；死亡14人，伤亡率38．89％。狭窄空间事故的特点是：伤员活动环境十分恶劣；活动特别受限制；被救助者的伤病多样性；被救助者的心理压力十分普遍；狭窄空间环境和伤员疾病复杂性决定了其医学救援的特殊性，较正常的外伤急救医疗有很大的区别。结论狭窄空间意外事故可造成惨痛的人员伤亡，其根本的原因就在于相关人员未能清楚认识到狭窄空间内部或邻近区域存在的危险或潜伏的危险，使得狭窄空间成为一个又一个“安静的杀手”。需引起大家的高度重视。Objective To investigate the characteristics of the confined space accident and its medical rescue strategy. Methods Thirty-six patients with emergency rescue in the five confined space accident during June 2009 to July 2012 were retrospectively analyzed. Results Twenty-nine people were caught in four confined space accidents caused by building collapse and 7 people were caught in one confined space accident caused by a tower of babel blast furnace damage which caused severe gas and hydrogen sulfide poisoning. For the 36 wounded, the shortest rescue time was 1.5 hours and the longest was 10.5 hours. Fourteen people were killed （mortality rate 38.89% ）. Characteristics of the confined space accident： the wounded activity environment was very harsh, the wounded were restricted particularly, the wounded injuries were diverse, the psychological depression was very common. The confined space environment and the complexity of wounded disease determined its medical rescue specificity and were very different from the usual trauma emergency. Conclusions Confined space accident caused very painful casualties. The key reason is that the relevant personnel failed to clearly recognize the potential risks in the confined space or nearby, making the confined space into another ＂quiet killer＂. This problem needs to be paid highly attention.

关 键 词：狭窄空间 医学应急救援 伤亡率 

分 类 号：X928.04[环境科学与工程—安全科学] R13[医药卫生—劳动卫生]