中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
Chinese Journal of Emergency Medicine
2015年
10期
1086-1090
,共5页
曾杰%江华%胡卫建%陈康
曾傑%江華%鬍衛建%陳康
증걸%강화%호위건%진강
地震%创伤%山地%致伤原因%受伤机制%救援%尼泊尔%病例分析
地震%創傷%山地%緻傷原因%受傷機製%救援%尼泊爾%病例分析
지진%창상%산지%치상원인%수상궤제%구원%니박이%병례분석
Earthquake%Trauma%Mountain%Injury reason%Injury mechanism%Rescue%Nepal%Case-analysis
目的 分析本次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 将本次尼泊尔博克拉8.1级地震后送至中国政府医疗队战地医院374例住院伤员按致伤原因分组,对其基本情况及伤情经行回顾性分析.结果 共纳入374例地震后送入院伤员.年龄(30.1 ±12.4)岁.其中,建筑物压砸掩埋伤组154例、逃生压砸伤组123例、逃生平地跌伤组58例及高处坠落伤组39例.确诊骨折者273例(296处)、严重多发伤者34例.高处坠落伤组年龄(22.3±7.4岁)明显低于其他组(均P＜0.05),逃生平地跌伤组年龄(48.4±13.3岁)明显高于其他组(均P ＜0.05).男性因高处坠落致伤的概率较大(14.2％:7.1％,x2=5.077,P=0.024),女性因逃生平地跌伤概率较大(19.7％:10.8％,x2=5.635,P=0.018).296处骨折中四肢骨折发生率最高(66.6％),逃生压砸伤组颅骨骨折发生率(31.6％)较其他组为高(均P＜0.05),高处坠落伤组脊柱骨折发生率(40.0％)较其他组为高(均P＜0.05);建筑物压砸掩埋伤组及高处坠落伤组多发伤发生率差异无统计学意义(16.9％:12.8％,x2 =0.381,P=0.537),但都显著高于逃生压砸伤组和逃生平地跌伤组(均P＜ 0.05).各类处置中创面处置最多(57.5％),其次为石膏托固定(30.9％).144例软组织裂伤患者中首次换药发现创口感染者25例(17.4％),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 本次中国政府医疗队收治的伤员存在年龄小、危重症少、创口感染率高的特点.各类骨折与开放性创面处理是医疗处置的重点.虽面临医疗设备简陋、药品匮乏等诸多困难,但是凭借多次参加国内地震灾害救援的经验积累,中国政府医疗队圆满地完成了任务.
目的 分析本次尼泊爾博剋拉地震後送傷員的傷情特點,總結中國政府醫療隊救援經驗.方法 將本次尼泊爾博剋拉8.1級地震後送至中國政府醫療隊戰地醫院374例住院傷員按緻傷原因分組,對其基本情況及傷情經行迴顧性分析.結果 共納入374例地震後送入院傷員.年齡(30.1 ±12.4)歲.其中,建築物壓砸掩埋傷組154例、逃生壓砸傷組123例、逃生平地跌傷組58例及高處墜落傷組39例.確診骨摺者273例(296處)、嚴重多髮傷者34例.高處墜落傷組年齡(22.3±7.4歲)明顯低于其他組(均P＜0.05),逃生平地跌傷組年齡(48.4±13.3歲)明顯高于其他組(均P ＜0.05).男性因高處墜落緻傷的概率較大(14.2％:7.1％,x2=5.077,P=0.024),女性因逃生平地跌傷概率較大(19.7％:10.8％,x2=5.635,P=0.018).296處骨摺中四肢骨摺髮生率最高(66.6％),逃生壓砸傷組顱骨骨摺髮生率(31.6％)較其他組為高(均P＜0.05),高處墜落傷組脊柱骨摺髮生率(40.0％)較其他組為高(均P＜0.05);建築物壓砸掩埋傷組及高處墜落傷組多髮傷髮生率差異無統計學意義(16.9％:12.8％,x2 =0.381,P=0.537),但都顯著高于逃生壓砸傷組和逃生平地跌傷組(均P＜ 0.05).各類處置中創麵處置最多(57.5％),其次為石膏託固定(30.9％).144例軟組織裂傷患者中首次換藥髮現創口感染者25例(17.4％),經積極正規的清創處理後,3d分泌物塗片轉陰率達72％,7d分泌物塗片轉陰率達100％.結論 本次中國政府醫療隊收治的傷員存在年齡小、危重癥少、創口感染率高的特點.各類骨摺與開放性創麵處理是醫療處置的重點.雖麵臨醫療設備簡陋、藥品匱乏等諸多睏難,但是憑藉多次參加國內地震災害救援的經驗積纍,中國政府醫療隊圓滿地完成瞭任務.
목적 분석본차니박이박극랍지진후송상원적상정특점,총결중국정부의료대구원경험.방법 장본차니박이박극랍8.1급지진후송지중국정부의료대전지의원374례주원상원안치상원인분조,대기기본정황급상정경행회고성분석.결과 공납입374례지진후송입원상원.년령(30.1 ±12.4)세.기중,건축물압잡엄매상조154례、도생압잡상조123례、도생평지질상조58례급고처추락상조39례.학진골절자273례(296처)、엄중다발상자34례.고처추락상조년령(22.3±7.4세)명현저우기타조(균P＜0.05),도생평지질상조년령(48.4±13.3세)명현고우기타조(균P ＜0.05).남성인고처추락치상적개솔교대(14.2％:7.1％,x2=5.077,P=0.024),녀성인도생평지질상개솔교대(19.7％:10.8％,x2=5.635,P=0.018).296처골절중사지골절발생솔최고(66.6％),도생압잡상조로골골절발생솔(31.6％)교기타조위고(균P＜0.05),고처추락상조척주골절발생솔(40.0％)교기타조위고(균P＜0.05);건축물압잡엄매상조급고처추락상조다발상발생솔차이무통계학의의(16.9％:12.8％,x2 =0.381,P=0.537),단도현저고우도생압잡상조화도생평지질상조(균P＜ 0.05).각류처치중창면처치최다(57.5％),기차위석고탁고정(30.9％).144례연조직렬상환자중수차환약발현창구감염자25례(17.4％),경적겁정규적청창처리후,3d분비물도편전음솔체72％,7d분비물도편전음솔체100％.결론 본차중국정부의료대수치적상원존재년령소、위중증소、창구감염솔고적특점.각류골절여개방성창면처리시의료처치적중점.수면림의료설비간루、약품궤핍등제다곤난,단시빙차다차삼가국내지진재해구원적경험적루,중국정부의료대원만지완성료임무.
Objective To analyze the feature of victims transported from Nepal Pokhara's earthquake,and summarized the rescuing experiences got by the Chinese government medical team.Methods A total of 374 casualties from the 2015 Nepal's earthquake magnitude 8.1 transported to the Field Hospital of the Chinese government medical team were classified into four groups according to different causes of injury,and then retrospectively analyzed the types of injury,vital signs,severity of injury and causes of injury.Results Of 374 casualties,the average age was (30.1 ± 12.4) years,and were divided into group A (n =154) in which casualties trapped under ruined buildings,group B (n =123) in which the victims had crushed injury during escaping with their lives,group C (n =58) in which the wounded had injury resulted from fall on the ground during fleeing for their lives and group D (n =39) in which the injury of casualties was caused by fall from high level.Of them,273 patients (296 parts of body injured) suffered from fracture including 34 patients with severe multiple trauma.The average age in the group D (22.3 ±7.4 years old) was significant younger compared with the others (all P ＜ 0.05).The average age in the group C (48.4 ± 13.3 years old) was significant older compared to the others (all P ＜ 0.05).The injury probability was higher for male in the group D (14.2％ vs.7.1％,x2 =5.077,P =0.024) and the injury probability was higher for female in the group C (19.7％ vs 10.8％,x2 =5.635,P =0.018).The incidence of limbs fracture was highest (66.6％) in all 296 parts of body injured.The incidence of skull fracture in the group B (31.6％) was higher compared to the others (all P＜0.05),and the incidence of spinal fracture in the group D (40.0％) was higher compared to the others (all P ＜ 0.05).There was no significant difference in the severe multiple trauma incidence between the group A and the group D (16.9％ vs.12.8％,x2 =0.381,P =0.537),but both group A and group D had significant higher incidence of severe multiple trauma compared to the rest two groups (all P ＜ 0.05).The wound debridement was the leading rate of treatment among variety of treatments (57.5％) and the plaster fixation was the second high rate of treatment (30.9％),and the wound infection was found in 25 patients (17.4％) at the first dressing among 144 patients with soft tissue laceration.After active and regular debridement,72％ patients' wound smear tests were negative 3 days later,and 100％ were negative 7 days later.Conclusions The casualties treated by Chinese government medical team had relatively young average age,not very severe critical illness,and quite high rate of wound infection.The treatment of all kinds of fractures and open wound was a matter of critical importance.Although facing the challenge of incomplete set of medical equipment,the lacking of medicine and many other unexpected problems,the Chinese government medical team successfully fulfilled the mission with the prior experience accumulated from several domestic earthquake disaster rescue actions.
