汶川地震和雅安地震伤员救治过程中医院感染预防与控制特点比较

Comparison of healthcare-associated infection prevention and control characteristics between Yaan earthquake and Wenchuan earthquake

目的通过比较汶川地震和雅安地震伤员医疗救治中的医院感染防控工作,探讨地震伤员救治中的医院感染防控特点。方法通过文献回顾和现场调查,了解两次地震伤员医疗救治的医院感染预防与控制工作特点并比较其异同。结果与2008年汶川地震的伤员救治工作相比,2013年雅安地震救治压力小,救治医院的医院感染防控应急能力有了明显提升,在预检分诊、气性坏疽的防治、目标监测和高危环节的干预方面都有了改进,并取得明显效果。临时帐篷医院的感染控制工作也在短期内步入正轨。结论良好的地震伤员救治医院感染防控,关键要做到"四早(早介入、早筛查、早隔离、早干预)、六需要(需要领导重视;需要多学科合作;需要个性化防控方案;需要将感染控制的理念与措施贯穿诊疗活动的全过程;需要采取科学规范的感染控制措施;需要配备合格的感染控制专业人员)",以保障灾后医疗救治中的医疗安全。

Objective To evaluate characteristics of prevention and control of healthcare-associated infection （HAI） during treatment for earthquake victims after Wenchuan earthquake and Yaan earthquake.Methods Field investigation and literature review were conducted to compare the characteristics of HAI prevention and control between two earthquakes.Results Compared with medical rescue after Wenchuan earthquake in 2008,the challenge after Yaan earthquake in 2013 was less,infection control emergency preparedness and response of hospitals,including preview and triage,prevention and control of emphysematous gangrene,targeted surveillance and intervention in high risk factors,improved obviously.Infection control in preliminary tent hospitals was on the right track.Conclusion The main characteristics of effective HAI prevention and control measures during treatment for earthquake victims are four early （early involvement,early screen,early isolation,and early intervention）and six demands （government attention,multidisciplinary cooperation,personalized prevention and control scheme,combination of infection theory with measures during the whole treatment process,scientific and standard infection control measures,professionals in infection control）,so as to ensure the medical safety of the treatment for disaster victims.