天津港“8·12”特大爆炸事件对爆炸冲击伤诊治的警示

Vigilance and enlightenment from diagnosis and therapy of blast injury in the “8·12” giant explosion in Tianjin harbor

2015年8月12日,中国天津港发生化学危险品特大爆炸事故,历经1个月的院内诊治,73.6%(587/798)伤员康复出院。本次特大爆炸事故教训惨痛,对我国和平时期爆炸冲击伤的诊治有重大警示效应。通过调研结合既往工作经验,可以发现爆炸冲击伤,伤因复杂、伤情多变;爆炸冲击伤非传统外轻内重模式,而是内外皆重、外伤不能掩盖内伤;由于大爆炸冲击伤伤员构成复杂、诊治难度较大;大爆炸冲击伤躯体外伤可治,精神创伤难愈。在诊治模式上,亟待加强爆炸冲击伤诊治集束化与规范化体系。总之,源头控制是关键,无论发展中国家还是发达国家,社会复杂矛盾决定了爆炸事故难于避免,预警诊断要占得先机,对远期的精神创伤须提到社会疾病的高度。唯有全社会实现稳定规范化支撑体系,才能在灾难面前实现政府和民众的和谐与共赢。

In August 12th,2015,an especially big bang of dangerous chemical goods happened in Tianjin harbor.Through a month of in- hospital diagnosis and therapies,73. 6%（ 587/798） of the wounded were released after recovering from the severe explosive blast injury.The giant explosive accident taught us a wretched lesson,and supplied important alerting effects for the diagnosis and therapy of explosive blast injury in Chinese peacetime. Through an in depth analysis combined with our previous working experiences,we found the blast injury in the giant explosions showed more complicated injury factors and state of an injury.In comparison with the traditional injury pattern in blast injury,most of the blast injury expressed the symptom of both heavey inside and outside while the external injury couldn＇t masking the internal injury.Owing to the complex compositions of the wounded,the treatment of blast injury is intractable due to the differential body injuries and psychological trauma. In the therapeutic patterns,it is urgent to strengthen the bundled and standardized system of explosive blast injury. Collectively,it is the key point to firmly control the explosive origin.The existing social conflict determined the explosive accidents remain difficult to be avoided.The ideal precaution diagnosis should be put ahead once explosion happens. The potential psychological trauma should be evaluated as a kind of social disease. Only when the standardized and steady social support system come true,then the harmony and win-win can be realized in the explosive disasters for the government and population.