中国政府医疗队尼泊尔地震救援中胸外伤救治分析  

Analysis on the rescue and treatment of thoracic injury of Chinese Government Medical Team in Nepal earthquake

作　　者：王雪海[1] 丁少夔 陈康[3] 胡卫建[3] 

机构地区：[1]四川省医学科学院.四川省人民医院胸外科,成都610072 [2]四川省医学科学院.四川省人民医院放射科,成都610072 [3]四川省医学科学院.四川省人民医院急救中心,成都610072

出　　处：《中华灾害救援医学》2016年第8期429-431,共3页Chinese Journal of Disaster Medicine

摘　　要：目的总结"4·25"尼泊尔地震胸部外伤的救治经验。方法回顾性分析中国政府医疗队所收治的尼泊尔地震伤员中35例存在或合并胸部外伤的临床资料,分析其临床特点和治疗效果。结果胸部受伤类型从高到低排序为皮肤软组织挫伤(97.1%)、肋骨骨折(94.3%)、肺挫伤(42.9%)、血气胸(8.6%)和胸骨骨折(2.9%)。合并胸部以外伤情者共18例(51.4%),其中合并伤类型最多的是锁骨骨折(14.3%)和椎体骨折(14.3%)。与创伤严重度评分(injury severity score,ISS)≤16分者相比,ISS>16分者需要急诊手术比例高(P=0.016),达到出院标准的时间延长(t=-6.307,P<0.001),差异有统计学意义。与低龄组(≤65岁)相比,高龄组患者(>65岁)的ISS[(10.6±4.2)vs(12.4±2.4)]和达到出院标准时间[(6.8±2.7)vs(8.1±1.6)]均有所增加,两组差异无统计学意义。结论地震导致胸部损伤以肋骨骨折及肺挫伤为主。早期行ISS及充分胸腔闭式引流对创伤伤员的及时救治有重要临床指导意义。Objective To summarize the experience of rescue and treatment of patients with thoracic injury in ＂4·25＂ Nepal earthquake. Methods Make a retrospective analysis on clinical information of the 35 patients suffering thoracic injury treated by Chinese Government Medical Team, including clinical characteristics and treatment results. Results Types of thoracic injuries were ranked as follows： skin and soft tissue contusion（97.1%）, rib fracture（94.3%）, pulmonary contusion（42.9%）, hemopneumothorax（8.6%） and sternal fracture（2.9%）. A total of 18 patients（51.4%） have other ailments except thoracic injury, the most common types of which were clavicle fracture（14.3%） and vertebral fractures（14.3%）. Compared with patients whose ISS ≤ 16, patients whose ISS16 had more proportion of acute operation（P=0.016） and longer days of stay in hospital（t=-6.307,P0.001）, and the differences were statistically significant. Compared with the younger group（ ≤ 65 years old）, the elder group（ 65 years old） had higher ISS [（10.6±4.2） vs（12.4±2.4）] and longer days of stay in hospital [（6.8±2.7） vs（8.1±1.6）], and there was no statistical difference between the two groups. Conclusions Rib fractures and pulmonary contusion are the main thoracic injuries in earthquake. Conducting ISS and thoracic closed drainage in the early stage plays a significant clinical role in timely rescuing and treating these patients.

关 键 词：地震 胸外伤 

分 类 号：R65[医药卫生—外科学]