玉树、芦山、九寨沟地震灾区巡诊疾病分析

Diseases analysis during medical tours following Chinese Yushu, Lushan and Jiuzhaigou earthquakes

目的分析玉树、芦山、九寨沟地震后1周内的巡诊情况,为今后高海拔山区的地震医疗救援提供经验。方法采取国际疾病分类法(international classification of diseases,ICD-10)收集整理资料,对三次地震后早期巡诊的疾病种类、年龄、高发疾病等进行回顾性分析。结果玉树、芦山、九寨沟震后巡诊伤病员包括:玉树4 129人次,男性45.36%(1 873/4 129),女性54.64%(2 256/4 129),平均年龄(62.6±26.9)岁;芦山2 740人次,男性47.23%(1 294/2 740),女性52.77%(1 446/2 740),平均年龄(66.3±31.5)岁;九寨沟424人次,男性48.58%(206/424),女性51.42%(218/424),平均(60.8±22.3)岁。三次地震中以急性胃肠道疾病发病率最高;急性胃肠道疾病在第2~4天为高发期,其中玉树、芦山地震第2~3天为快速上升期,九寨沟地震第2~3天均居高位;3 d后发病人次减少,至7 d时发病人次同震后1 d相当。结论自2008年汶川地震后,我国大地震的伤亡人数迅速递减,归结于国家的地震教育普及和高效联动救援、居民的防震意识和自救能力的迅速提升、医疗救援力量的及时干预等。交通条件不佳、医疗力量短缺的山区强震后,均无高发疾病或疫情出现,与地震灾害后的无死角医疗巡诊密不可分。灾害后的巡诊可大范围地满足受灾群众的医疗及心理需求,尽早发现易感疾病及易感人群,有效预防传播性疾病的发生及发展,是地震救援环节的重要组成部分。

Objective The objective of this study was to analyze the situation of diseases during medical tours within one week of Yushu, Lushan and Jiuzhaigou earthquakes respectively, and to provide references for future medical rescue for earthquakes in high mountain areas. Methods The data were collected and collated using the International Classification of Disease Method （ICD-10）. The disease categories, ages of victims and frequently occurred diseases were retrospectively analyzed in the early medical tours shortly after the three earthquakes. Results The numbers of the wounded in these three earthquakes 4,129 wounded in Yushu earthquake, among whom male accounted for 45.36% and female 54.64%, and the average age was （62.6±26.9） years; 2,740 in Lushan earthquake with male making up 47.23% and female 52.77%, and the average age was （66.3±31.5） years; 424 in Jiuzhaigou earthquake with male taking up 48.58% and female 51.42%, and the average age was （60.8±22.3） years. The acute gastrointestinal diseases occurred most frequently in the three earthquakes. Acute gastrointestinal disease peaked on the 2nd to the 4th day following the earthquakes; specifically speaking it ascended from the 2nd to 3rd day in Yushu and Lushan earthquakes, and peaked on the 2nd and the 3rd days in Jiuzhaigou earthquake. The incidence of the disease decreased 3 days after the earthquakes, and the number of the infected on the 7th day was on par with that of the 1st day. Conclusions The number of casualties has rapidly declined since the Wenchuan earthquake in 2008. This can be attributed to the nation＇s earthquake education and efficient coordinated response, residents＇ awareness of earthquake prevention and self-rescue capability improvement, and medical rescue forces＇ timely intervention. Post-disaster medical patrol can meet the medical and psychological needs of the affected people in a wide range. Susceptible diseases and populations should be identified as early as possible and given effective prevention, and such effort is an indispensable part in the earthquake rescue.