对我国西部地区创伤救治现状的考察及思考  

Investigation and Reflection on the current situation of trauma treatment in Western China

作　　者：熊建[1,2,6] 黄博轩 郎克 Henry Xiang 王天兵 XIONG Jian;HUANG Boxuan;LANG Ke;Henry Xiang;WANG Tianbing(Department of Trauma&Orthopedics,Peking University People's Hospital,Beijing 100044,China;不详)

机构地区：[1]北京大学人民医院创伤骨科,北京100044 [2]国家创伤医学中心,北京100044 [3]青海省黄南藏族自治州人民医院,青海省黄南藏族自治州811399 [4]Center for Pediatric Trauma Research&Center for Injury Research and Policy,Nationwide Children's Hospital,The Ohio State College of Medicine,Columbus,OH 43210 [5]北京大学人民医院创伤救治中心,北京100044 [6]创伤救治与神经再生教育部重点实验室,北京100044

出　　处：《中国急救复苏与灾害医学杂志》2023年第8期1008-1012,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的通过对青海省黄南藏族自治州的短期走访考察,探讨我国以青海省为代表的西部边远高原地区创伤救治体系及创伤中心建立的条件,设计及实施方法。方法2018年8月对青海省黄南藏族自治州所辖的4个县(尖扎县,河南蒙古族自治县,泽库县,同仁县)进行了为期1个月的实地走访考察,初步调查了4个县人民医院的基本急诊急救情况,对各医疗机构的规模,科室设置,患者类型,地理、人文情况,以及医疗机构间的交通、路况等进行了实地的考察与座谈。结果4所县人民医院均为所在县最大的且唯一的二级甲等西医综合性医院,主要负责辖区内百姓的慢病治疗、公共卫生以及创伤患者的救治。创伤为各家医院急诊疾病谱中的第一位疾病。黄南藏族自治州为高原地区,4所州人民医院的平均海拔为2928.2 m,汽车为创伤急救及转运的唯一交通工具,4所医院之间的平均汽车时间为122.5 min,4所医院间的平均车程为110.2 km,4所医院距青海省创伤救治中心的平均车程为199.25 km,汽车时间平均为175 min。尖扎县、河南蒙古族自治县、泽库县3个县规模较小,只设有综合内科及综合外科。急诊科正在建设或建立不久,缺乏合理规范的救治分区,设备尚齐备,但人员缺乏系统规范培训。结论以青海省黄南藏族自治州为代表我国西部高原地区,自然气候条件恶劣,随着西部大开发及经济建设的高速发展,创伤发生率高,但相应的救治条件和水平有待提高,建立以省会医院为创伤医学中心,州人民医院为创伤救治中心,县人民医院为创伤救治点的符合地域特点的区域性创伤救治体系并大力开展创伤从业人员相关培训可以提高当地的创伤救治水平。Objective To discuss the conditions,potentials and challenges in establishing a comprehensive trauma treatment system and trauma center establishment in remote western plateau areas represented by Qinghai Province,China through site visits and focus group discussions in Huangnan Tibetan Autonomous Prefecture of Qinghai Province.Methods In August 2018,four counties(Jianzha County,Henan Mongolian Autonomous County,Zeku County,Tongren County)under the jurisdiction of Huangnan Tibetan Autonomous Prefecture in Qinghai Province were visited and focus group discussions with local leaders and patients were conducted.The basic emergency treatment situation of the local hospitals in four counties was examined.Common diseases and medical conditions treated,department settings and patients were also investigated.The type,geography,humanities,transportation and road conditions between medical facilities were investigated and discussed with local leaders.Results All the four county people's hospitals were the largest and only classⅡclass A comprehensive western medicine hospital in the county.They were mainly responsible for the treatment of chronic diseases,public health,and trauma patients.Trauma was ranked no.1 among all diseases and conditions treated by the emergency department of hospitals.Huangnan Tibetan Autonomous Prefecture was a plateau area.The average elevation of the four prefectures'local hospitals was 2928.2 meters.Automobiles were the only means of transportation for emergency care and transfer of trauma patients.The average time of automobile transportation between the four hospitals was 122.5 minutes.The average distance between the four hospitals was 110.2 kilometers.The average distance of the four hospitals to the central trauma center of Qinghai Province was 110.2 kilometers.With a distance of 199.25 km and an average time of 175 minutes,the three counties in Jianza County,Henan Mongol Autonomous County and Zeku County were small in scale and only have comprehensive internal medicine and surgery.Conclu

关 键 词：创伤 西部地区 转运 急救体系 交通 民族 

分 类 号：R459.7[医药卫生—急诊医学]