中国国际救援队在巴基斯坦地震救援中的医学实践与研讨

The discussion of medicine service in pakistan earthquake rescue mission

目的 探讨进一步提高国际层次救援医学速度与效率.方法 以中国国际救援队医疗行动为主体,对2005年赴巴基斯坦地震系列医疗救援行动,包括:现场急救、院内治疗、医疗后送、卫生防疫、药械保障、医疗信息管理进行回顾性分析,特别是对救治的伤病员分类、灾后时段病种分布、药品消耗及补充等进行统计学分析.结果 院外、院内及院后救治统计:现场急救以外伤为主,以小组形式展开;院内治疗划分小组,分组协作、周而复始;转出比例占2%～3%;灾后时段伤病员分析:地震灾害早期(灾后头14 d内)现场救治,以外伤为主,占救治伤病员总数的82%;中期(灾后14～28 d)外伤病人所占比重逐渐下降,稳定在24%,而感染性疾病逐渐增加,并以急性呼吸道感染及急性肠炎为主,呼吸道疾病呈陡升缓降趋势;后期则回归于当地平时发病率水平.药械保障统计:消耗量较大的药品有抗生素,退热与止痛药,主要用于外伤及感染;药品以口服和外用为主,针剂和输液占10%.伤病救治影响因素统计:灾区山地昼夜温差大,冬季雨雪之后气温骤降,灾民缺衣少食,没有可供御寒的帐篷成为诱发疾病的重要原因.结论 大规模地震灾害救援行动异常复杂,区分时段、区分地段、区分层次形成时间、空间、内容上的不同救援,更能符合灾区医疗需求;医疗救援能力始终未能满足灾区的医疗需求,要求不断完善组织管理体系,实现救助人数更多、速度更快、效果更好、能耗更省;灾害救援的技术行动、组织指挥与生活保障,三足鼎立,决定救援行动成败;巴基斯坦地震医疗救援的实践对我国灾害医学救援的组织体系、技术训练、药械保障、制度管理提供了借鉴与参考.

Objection On 8 Ocotober 2005, an earthquake measuring 7.9 occurred in Pakistan. >75 000 people were killed, and 100 000 were injured. This is a retrospective study based on the medical records of earthquake patients dispatched to mobile hospital. Study on the model of medicine service in the disaster rescues mission, developing the ordinary order of the medicine list for disaster rescue. Method Both of the types and quantities of the patients were analyzed, considering the kinds and quantity of medicine, the consumption and supply situation of medicine in the mission. Results The national and international responses would be quicker, large numbers of patients were evacuated from their homes and transported to hospitals when the field hospitals were created, nearly 591 patients were transferred to Chinese mobile hospital in disaster area within the first rescue mission after the earthquake.2 194 patiems were transferred to Chinese mobile hospital during the second mission. In the early stage, the earthquake disaster take the flesh wound as the focus and the flesh wound in first 14 days is on the top ;In the intermediate stage, infectious disease gradually increases and take the acute respiratory tractinfection and the acute enteritis as the focus; Later period all rations go back to usual level, the antibiotic, antipyretic and the pain-killer consumption is large ; Oral and external medicine were used widely, the injection and the infusion accounts for 10%; the temperature between the day and night in the mountainous region is huge, the clothes and food lacking ,and no tent toprotect against the coldness ,all the reasons cause a lot of patients. Conclusion The rescue should change according to stages and the kind of disease; It is necessary that more medicine should be supplied to children and pregnant ;mobile hospital can build a new channel to provide emergency medicine service in the earthquake disaster area. From the consumption of drugs and referenced on the contents of medicine for the international rescue mission. It is an advantage to develop the our country's emergency ability learning form the international rescue mission