摘要:目的:探討地震傷員中膝關節損傷的機制、類型及處理方法。 方法:對我院收入住院的2728例 5·12汶川特大地震傷員傷情特點進行分析,篩選出有膝關節損傷的病例進行分析。 結果: 膝關節損傷前三位分別是髕骨骨折(42.15%)、脛骨平臺骨折(21.05%)、股骨髁骨折(13.16%),這與人們在地震時奔跑摔傷以及被房屋倒塌砸傷有很大關系。結論:地震后膝關節損傷其發病率、受傷機制、損傷類型、合并傷情況及治療處理均有其特點,總結這些特點和規律將對地震傷膝關節損傷患者的處理產生積極作用。Abstract: Objective: To investigate the knee joint injury mechanisms, types and treatment of the earthquake wounded. Methods: Analysis the characteristics of the 2728 cases of West China Hospital from 5.12 Wenchuan earthquake wound, screen out the cases of knee joint injury. Results: Patellar fracture (42.15%),tibial plateau fracture(21.05%), femoral condyle fracture (13.16%), were the top three of knee joint injuries, which have a great relationship with falling down and (or) injured by collapsed houses when people were running in the earthquake. Conclusion: After the earthquake the knee joint damages its disease incidence rate, is injured the mechanism, the damage type, the merge wound situation and treatment processing has its characteristic, will summarize these characteristics and the rule damages patient’s processing to the earthquake wound knee joint to have the positive role.
Objective To analyze the performance of epidemic prevention of Sichuan Province in the reconstruction stage after Wenchuan earthquake, so as to provide references for future epidemic prevention when such emergencies occur. Methods Data about the relief work were collected from the archives of Centers of Disease Control and Prevention in earthquake-stricken areas. And then the data were classified and analyzed. Results In the reconstruction stage, epidemic prevention followed principals of local-based, local-management, assistance-relied and joint -forces-pushed. The strategies included strengthening the capacity of CDCs through personnel training and improving abilities of hygiene service. Owing to these strategies, the epidemic prevention in Sichuan Province was conducted vigorously, orderly and effectively. Conclusion The epidemic prevention strategies in the reconstruction stage in Sichuan Province are accurate and effective, which could be recommended when such emergencies occur in future.
Objective To summarize the experience of preparation and administration of medical materials for the daytime-sickroom during the treatment of patients who were injured during Wenchuan earthquake in order to supply management experience for future emergency situations. Methods Data concerning the preparation and administration of medical materials and medical treatment for the daytime-sickroom were collected systematically. Results The high level of activity and order during the rescue provided quality care to patients injured in the earthquake. All 224 patients were treated effectively from May 12-29.Conclusion The daytime-sickroom acts as a combination sickroom, which allowed flexibility. The daytime-sickroom can manage medical materials and succesfully insure the treatement of patients when emergent events happen.
To retrospectively summarize the medical rescue organization and strategy of West China Hospital medical team during the Wenchuan earthquake so as to provide reference for rescue practice in the future. We emphasize that the key point to improve the efficiency of rescue is scientifically assigning and util izing medical resource according to the demand at the actual locale of the earthquake and the characters of various stages of the earthquake .
Objective To evaluate the psychological trauma incurred by the people in wenxian after the Wenchuan earthquake so as to provide relevant information for psychological and medical interventions. Methods Thepsychological state of the people after the earthquake was investigated using a mental health self-assessment questionnaire, self-rating anxiety scale, and self-rating depression scale. Results We found: 56.0% of the respondents were not happy, 39.6% often cried bitterly, 56.7% felt pain, 40.7% lost interest, 69.2% felt uneasy, nervous, or worried, and 27.0% would like to end their lives; the SDS scores (56.48±110.43) and SAS scores (39.88±11.38) of the people were significantly higher than those of the national norms (Plt;0.001). The following symptons appeared: 59.3% had headache, 50.5% poor appetite, poor sleeping 56.0%, 58.2% were easily frightened, tremors 29.7%, 50.5% dyspepsia, 42.9% thoughts fuzzy, 60.4% stomach discomfort, fatigue 85.7%. Conclusion The earthquake disaster brought about serious psychological harm to people. It is necessary to strengthen post-earthquake psychological relief and strengthen interventions in order to reduce the psychological suffering of victims.
Objective To explore the structure and influencing factors of overall medical treatment expenses of 1 635 inpatients of Wenchuan earthquake in West China Hospital and to provide references for setting up the criteria of medical expenses and for assess the cost-effect of medical rescue and treatment. Methods The data of earthquake casualties were collected to analyze the constitution and influencing factors of the overall medical expense by SPSS 13.0 software. The data were described by X±SD. Comparison of data categories was tested by rank sum and influencing factors were analyzed by multi ple l inear regression analysis. Results A total of 1 635 casualties including 1 413 (86.04%) earthquake wounded and 222 (13.96%) patients from the disaster area were identified. The average expense per capita was 9 165.05±12 426.11 yuan. The overall cost was made up of operation expenses (71.75%) including material cost, examination fee and treatment fee, drug cost (18.41%) as well as bed fee and others (less than 10%). The cost of patients from the disaster area was higher than that of the earthquake wounded (Z= –4.109, P=0.000). The operation, compl ications, multiple-site damages, injures induced by the secondary disaster of the earthquake such as burn and corrosion were the direct reason leading to the high overall expense. The influencing factors included operation (r=0.386), ICU (r=0.336) and the day of hospital ization (r=0.246). Conclusion The earthquake wounded occupy the predominant percentage of the earthquake inpatients in West China Hospital. The operation, compl ications, multiple-site damages and injures induced by the secondary disaster of the earthquake lead to a high overall expense. The influencing factors include operation, ICU and the day of hospital ization. The relationship between the expense and the disease category largely depends on the classification criteria. The relationship between the expense and the age as well as the prognosis needs further study. But no correlation between the expense and the gender is found.
Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios. Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.? Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples. Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
During the medical rescue of Wenchuan earthquake, the Nursing Department of West China Hospital of Sichuan University immediately initiated the emergency response plan, reasonably dispatched nurses of the medical teams from West China Hospital, other provinces and foreign countries. Meanwhile, the Nursing Department set up the medical team for emergency treatment, provided the basic information of the wounded, established the flow of rapid registration and rapid preview, formulated and optimized the flow of the admission of the wounded, and improved the flow of information-collecting. What’s more, the nursing department adjusted the current work according to the situation of hospitalization of the wounded in different stages to ensure the efficient running of medical rescue. Moreover, the routine nursing practice was also maintained and none of the inpatients other than those from the disaster area got involved in any unexpected accident.
Objective To investigate the quality of life (QOL) of Beichuan cadres 1 year after Wenchuan earthquake, so as to provide references for promoting psychological intervention and improving QOL. Methods With the adoption of WHOQOL-BREF, questionnaire survey on basic conditions of cadre victims, and PCL-C scale, cross-section survey was conducted for 2 055 cadres of Beichuan public institutions in aspects of their QOL, social demographic characteristics and psychological trauma. Results a) Compared with domestic norm, although the Beichuan cadres had higher score in social relation domain (14.31 ± 2.59, Plt;0.01), their QOL scores in each dimensions (physical domain score: 14.16 ± 2.43; psychological domain score: 13.79 ± 2.59, environmental domain score: 11.20 ± 2.74) were lower with significant difference (Plt;0.01); b) The group with population under the age of 30 scored higher than other age groups in the psychological and environmental domains; men scored higher than women in the psychological domain; the widowed group scored lower than other groups in all domains; the Han nationality group scored higher than the Qiang nationality group in all domains; the primary education group scored lower than other groups in the social relation domain; the group with relatives, houses and physical loss or damage scored lower than the non-loss group in all domains; and the higher the score in PCL-C, the lower the scores in all domains (all Plt;0.05). Conclusion Beichuan cadres are severely affected in their physical, psychological and environmental domains even one year after Wenchuan earthquake, especially the female, the Qiang nationality, the old, the lost, and the psychological injured cadres are more badly affected with worse QOL, so those population should be concerned in particular with sustainable psychological service and other measures. The finding of social relation domain score being higher than general population suggests that it is important to promote the satisfaction with social relation through the timely effective support from both government and civil society, and the resettlement of sample housing area as well.
