地震医疗救援模式的国际比较:一项基于尼泊尔和汶川地震后送伤员的回顾性病例对照研究  

International Comparison of Medical Rescue Models in Earthquake: A Retrospective Case-Control Study Based on the Woundedin Nepal and Wenchuan Earthquake

作　　者：曾杰[1] 江华[1] 

机构地区：[1]四川省人民医院急救中心外科,四川成都610072

出　　处：《四川医学》2016年第12期1315-1318,共4页Sichuan Medical Journal

基　　金：2014年四川省卫生厅资助课题(编号:30305030785)

摘　　要：目的分析2015年尼泊尔博克拉地震后送伤员的伤情特点,总结中国政府医疗队救援经验。方法采用及t检验将2008年汶川8.0级地震后送至四川省人民医院急救中心外科住院伤员与本次尼泊尔博克拉8.1级地震后送至中国政府医疗队战地医院住院伤员的基本情况、致伤原因及伤情经行对比分析。结果共纳入815例地震后送入院伤员,其中汶川地震后送伤员组441例,尼泊尔地震后送伤员组374例。汶川地震后送伤员组与尼泊尔地震后送伤员组在年龄结构[(44.3±2.6)vs.(30.1±4.4)]、致伤原因(高处坠落致伤率:25.2%vs.10.4%;逃生压砸致伤率:18.4%vs.32.9%)、损伤程度(骨折率:88.9%vs.73.0%;多发伤率:22.9%vs.9.1%)及首次换药发现创口感染率(9.4%vs.17.4%)方面差异有统计学意义(P<0.05)。尼泊尔地震后送伤员组创口感染的25例患者经积极正规的清创处理后,3d分泌物涂片转阴率达72%,7d分泌物涂片转阴率达100%。结论由于地域、文化、医疗水平的差异,本次战地医院接诊的尼泊尔地震后送伤员伤情有别于汶川地震伤员,但通过合理配置资源,坚持科学救治原则,中国政府医疗队圆满地完成了任务。Objective To analyze the injury characteristics of the wounded in Pokhara,Nepal after the earthquake in2015,and summarize the rescue experience of Chinese government medical team. Methods The basic conditions,causes and injury of the wounded that were sent to the emergency centerof Sichuan Provincial People＇s Hospital in Wenchuan 8. 0 earthquake and to the Chinese government medical field hospital in Nepal,Pokhara8. 1earthquake were compared and analyzed by χ^2 and t test.Results A total of 815 patients were admitted to hospital after the earthquake. Among them,441 cases were from Wenchuan earthquake and 374 cases were from earthquake in Nepal. The age structure [（ 44. 3 ± 2. 6） vs.（ 30. 1 ± 4. 4） ],the causes of injury（ high falling injury rate： 25. 2% vs. 10. 4%; escape crush injury rate： 18. 4% vs. 32. 9%）,the degree of injury（ fracture rate：88. 9% vs. 73%; multiple injury rate： 22. 9% vs. 9. 1%） and the infection rate of wound in the first dressing（ 9. 4% vs. 17. 4%）in Wenchuan earthquake wounded group and Nepal earthquake wounded group were significant different（ P〈0.05）. After active and formal debridement treatment of 25 cases from Nepal earthquake wounded group,the negative conversion rate of secretion smear was 72%,3d,and 100%,7d. Conclusion Due to the difference of region,culture,and medical level,the wounded patients in Nepal earthquake sent to the field hospital were different from the wounded in Wenchuan earthquake. But by rationally allocating resources and upholding the principle of scientific treatment,Chinese government medical team successfully completed the task.

关 键 词：地震 致伤原因 受伤机制 救援 

分 类 号：R129[医药卫生—环境卫生学]