成都市第三人民医院院内救治汶川地震伤员563例分析

Analysis of the earthquake wounded in the Third People's Hospital of Chengdu after the Wenchuan earthquake

目的分析成都市第三人民医院救治汶川地震骨伤伤员的总体情况,为今后完善和健全地震灾害应急预案机制提供决策参考。方法收集汶川地震后至2008年7月12日8时本院收治的骨伤伤员的入院信息及救治效果资料,经过二次交叉核对后用SPSS11.5统计软件分析。结果我院共收治563例地震伤员,包括门诊伤员249例,住院伤员314例,其中男287例,女276例;中位年龄门诊伤员42岁(28～57岁),住院伤员46岁(33～65岁),住院伤员年龄明显大于门诊伤员(P=0.003);住院伤员中骨伤231例,占73.56%,其中男108例,女123例;门诊伤员集中在震后前3天,占73.50%,而住院伤员震后前3天不足50%,住院伤员在震后72小时达最高峰,持续至震后9、10天后明显减少,相应时段骨科医生与伤员数量比分别为(1:6.4,1:5.6,1:4.2);伤员主要来自都江堰市、阿坝州和彭州市;伤情分类前3位为骨科(69.3%),神经外科(15.6%),普外科(3.7%);住院骨科伤员死亡率为0,破伤风及气性坏疽发病率为0,骨筋膜室综合症3例4肢因转入我院时已发生坏死而行截肢术。结论总结汶川地震医疗救援经验,建立地震灾害医疗救援应急预案,有针对性地加强硬件建设、物资储备和人员培训,科学现场分检与信息平台建设,同时政府要科学合理的利用医疗资源。

Objective To analyze the overall information of the wounded in Chengdu 3rd people＇s hospital after the Wenchuan earthquake so as to provide references for the future emergency response planning for earthquakes. Methods Demographic data and treatment results of the wounded admitted to our hospital from right after the Wenchuan earthquake to July 12th 2008 were collected and analyzed using the software SPSS 11.5 after 2-time data cross-check. Results A total of 563 cases including 287 males and 276 females had been treated in the hospital ,of whom 249 in the outpatient department and 314 in the inpatient department with a median age of 42 years （28,57） in the outpatient department and a median age of 46 years （33,65） in the inpatient department. The age of the inpatients was older than that of the outpatients （P = 0.003）. Among the 563 patients,231 cases （73.56%） were orthopedic wounded （108 Males and 123 Females ）. A majority of outpatients was sent to the hospital within the first 3 days after the quake （73.5%）,while less than 50% of all the inpatients were sent to the hospital during this same time frame. The number of the wounded continued to increase and the peak with the most arrivals of the wounded started from the 72 hours after the disaster and lasted to the 9th day after the quake. And after the 10th day the inpatient flow dropped quickly. During these 3 periods,the ratio of orthopedic doctors to the wounded were （1：6.4,1：5.6,1：4.2） respectively. The wounded came mainly from the city of Dujiangyan,the Aba prefecture and the city of Pengzhou. Most of the inpatients were in the orthopaedics （69.3%）,Neurosurgery （15.6%） and General surgery depatement（3.7%）. Among all the orthopedic wounded there was no mortality,no incidence of Tetanus and Gas gangrene. There were 3 cases of amputation due to bone compartment syndrome. Conclusion Based on the data,it is of vital importance to develop an emergency plan for the medical rescue after an earthquake disaster,and to strengthen the medical infrastructure construction,medical resourses reservoir and medical personnel training targeted at the earthquake medical rescue,to build up a scientific on-site triage system and medical information sharing platform,meanwhile medical resources should be utilized scientifically and efficiently by the government.