集中救治 动态检伤 多学科合作：在重症医学平台上对地震伤员实施联合救治

Centralization, dynamic triage and multidisciplinary teamwork on the platform of critical care medicine： the key of success during the rescue of 4.20 Lushan earthquake victims

目的总结第二批“国家医疗专家组”参加和指导2013年4月20日四川芦山地震伤员救治工作的经验，分析我国对地震灾难伤员医疗救治的现况。方法与结果在芦山地震救援中，医疗抢救明确了“集中伤员、集中专家、集中资源、集中救治”的“四个集中”原则，做到了集中重症伤员迅速转运，多环节兼顾；实行前线流动方舱、区域转运枢纽、后方救治中心的多环节串联；多学科专家团队和主管医生合作沟通，动态多次排查检伤，及时识别与治疗危重伤员；迅速摸清震伤特点，建立适当的多学科、多层次专家队伍，根据震情和伤情的不同及时调整救治队伍，做到岗位不同、派出的专家层次不同，充分发挥了医疗专家的最大作用；同时重视临床医学与康复医学的早期结合，最大程度地降低危重伤员的伤亡率和致残率。结论“4·20”芦山地震的医疗救援是近年我国地震医疗救治经历中的典范，体现了及时、有力、迅速、科学、高效的特点；“集中伤员、集中专家、集中资源、集中救治”的“四个集中”原则是医疗抢救成功的根本保证。

Objective To summarize the rescue experiences of the 4· 20 Lushan earthquake victims by the 2nd ＂National medical experts team＂ and analyze the current emergent therapies for earthquake victims in China. Methods and Results Principles of ＂four centralization＂ （centralized the victims, the medical experts, the equipments and treatment） during the rescue of Lushan earthquake were clarified to transport the critical victims to the central hospitals as soon as possible, and cover the several aspects at the same time; and to set up a multi-series connection among the mobile ambulance hospital in epieentral area, the triage/transfer hub in surrounding area as well as the central hospitals in rear. A multidisciplinary and multi-level experts team according to the different characteristic of each wave of earthquake, cooperation between the national multidisciplinary experts team and the local health care workers, and dynamic multi-time triage were built to detect the critical or potential critical victim in time. Clinical therapy was performed with rehabilitation medicine in early stage. All of above were our successful experiences leading to the minimization of mortality and disability of the earthquake victims. Conclusions The rescue of the 4 ·20 Lushan earthquake victims is an example in recent years, characterized by timely, powerful, rapid, scientific and highly efficient. The principle of ＂four centralization＂ （centralized the victims, the medical experts, the equipments and the treatment） is a fundamental guarantee for successful rescue.