地震应激伤员心理健康状态及其睡眠状况的调查

目的探讨地震应激伤员心理健康状态及其睡眠状况。方法采用症状自评量表和阿森斯失眠量表,对34例因地震所致应激状态的伤员进行调查。结果地震伤员症状自评量表评分为(148.25±42.33)分,躯体化、抑郁、焦虑、恐怖因子得分高于常模(P<0.01或P<0.05),强迫、人际关系敏感及妄想因子得分低于常模(P<0.01)。不同睡眠状况伤员的症状自评量表均分及各因子得分比较,差异均具有统计学意义(P<0.01或P<0.05)。结论地震伤员的心理状态与睡眠质量相关,临床护理工作者应关注伤员的心理状态,促进其睡眠质量的提高。     

107例地震多发伤的院内救治分析

目的：分析本院在芦山地震致多发伤的院内救治特点及救治方法,探讨降低急救死亡、伤残率,提高边远小医院内现场急救成功率。方法：回顾分析总结2013-04-20芦山地震致多发伤的院内现场救治资料。结果：本组抢救成功107例,死亡0例,死亡率0%。结论：地震所致多发伤病情急,人数多,诊治难度大,加强和提高院内应急预案,合理利用医疗资地,尤其是利用先进的远程会诊设备,通过及时合理地转诊重诊地员将会降低急救死亡、伤残率,提高院内现场急救成功率。     

地震相关性眼病

地震后常见的眼部疾病有结膜下出血、眼附属器损伤、眼眶骨折、眼球破裂伤等,地震伤害所造成的循环系统异常或炎症相关的特殊眼病包括远达性视网膜病变、挤压综合征、Terson综合征、Valsalva视网膜病变、颈髓挥鞭样损伤视网膜病变等,地震造成环境改变的相关眼病有视网膜光损伤、结膜炎等,地震造成心理因素变化引起的相关眼病有内源性葡萄膜炎、中心性浆液性脉络膜视网膜病变等.了解地震造成的眼部损害,在生命体征平稳后及时救治,以最大程度恢复视功能.     

骨科在突发地震灾难中合理流程救治的探讨

目的:探讨骨科在突发地震灾难中的合理流程救治。方法:收集我院2013年4月20日雅安市芦山县发生7.0级大地震后我院骨科应急处理方案及治疗情况。结果:我院骨科灾后迅速启动应急方案,人员合理分工,充分利用卫计委骨科、康复、护理专家,病员合理筛查,及时手术、护理及康复,我科共收治伤员198人,实施手术98台,所有伤员实现了未发生一例死亡、一例感染目标。结论:我院骨科在突发灾难面前科学合理安排,合理分工,充分利用外来资源,骨科治疗能有序有效推进,患者能及时得到最佳治疗,早期护理、康复介入、心理疏导,值得医院面对大灾中推广。     

Stress responses of emergency services personnel to the loma prieta earthquake interstate 880 freeway collapse and control traumatic incidents

A three-group quasi-experimental design contrasted the responses of rescue workers to the 1989 Loma Prieta earthquake Interstate 880 freeway collapse (n=198) with responses to critical incident exposure of Bay Area Controls (n=140) and San Diego Controls (n=101). The three groups were strikingly similar with respect to demographics and years of emergency service. The I-880 group reported higher exposure, greater immediate threat appraisal, and more sick days. The three groups did not differ on current symptoms. For the sample as a whole EMT/Paramedics reported higher peritraumatic dissociation compared with Police. EMT/Paramedics and California road workers reported higher symptoms compared with Police and Fire personnel. Nine percent of the sample were characterized as having symptom levels typical of psychiatric outpatients. Compared with lower distress responders, those with greater distress reported greater exposure, greater peritraumatic emotional distress, greater peritraumatic dissociation, greater perceived threat, and less preparation for the critical incident.     

平时罕见,特殊情况下发生的几种伤病

一些损伤和疾病平时罕见，特殊情况下可以发生，造成严重危害。特殊情况主要包括严重事故、灾害、战争、恐怖主义活动以及特殊环境与特殊作业的危害等。本阐述了现代战争中发生的贫铀武器伤害、燃料空气炸弹伤害、微波武器伤害和战时精神疾病；可能源于恐怖主义活动的炭疽、天花；严重事故性伤害中的核事故、化学事故和煤矿事故伤害；严重灾害中的地震、海难(海战)落海伤害。中介绍了这些伤病的发生情况、伤害特点与医学救治。     

地震灾后儿童群体性免疫预防实施情况分析

目的及时总结“5．12”汶川大地震灾后甲肝、乙脑疫苗预防接种工作经验，为自然灾害后开展群体性免疫预防工作提供参考。方法按照《江油市地震后甲肝、乙脑预防接种实施方案》开展群体性接种工作。对彰明镇等4个乡镇实施技术指导、现场督导和接种率快速评估。结果4个乡镇甲肝疫苗报告接种率为97．2％（3666／3773），乙脑疫苗报告接种率为99．2％（1389／1400）。快速评估共调查180名儿童，甲肝疫苗接种率为98．1％（155／158），乙脑疫苗接种率为97.3％（73／75）。快速评估结果与报告接种率基本一致。结论本次地震灾后群体性接种活动进展顺利，达到预期指标。灾后开展群体性预防接种需加强调配和培训医务人员，做好接种对象摸底工作．确保安全的接种场所．提供足够疫苗和冷链设备等。     

Kobe earthquake and reduced sperm motility

We investigated a possible relationship between the Kobe earthquake(January 17, 1995) and the quality of semen. We assessed spermconcentration and motility of 27 male patients who had a concentrationof more than 30 million/ ml and >40% sperm motility within5 months before the earthquake. Twelve male patients from districtswith a magnitude of <4 on the Richter scale showed no differencein sperm concentration and motility before and after the earthquake.Of 15 male patients from districts with a magnitude of >6,five patients whose houses received no damage showed no distinctchanges in sperm concentration and motility. In contrast, 10patients whose houses were partially or completely destroyedshowed significantly (P < 0.001) lower sperm motility afterthe earthquake than before, although no significant differenceof sperm concentration could be observed. Of these latter 10patients, seven could be followed. In six patients, sperm motilitywas restored between 2 and 9 months after the earthquake; thesperm motility in one patient, whose father died a victim ofthe house crash, has not yet recovered. Thus, the acute stressresulting from such a catastrophic earthquake could be a possiblecause of reduced sperm motility.     

唐山大地震所致截瘫患者远期心身健康状况调查研究

目的 :研究唐山大地震所致截瘫患者远期心身健康状况。方法 :6 4例唐山大地震所致截瘫患者和 6 4例对照组完成了唐山大地震心身健康调查问卷和标准化评定工具的调查、评定和诊断。结果 :6 4例截瘫患者中有 6例患延迟性应激障碍 (posttraumaticstressdisorder ,PTSD)。PTSD现患率为 9 38%,显著高于正常人群中PTSD的抽样调查结果。 6 4例截瘫患者有 32例地震后发生急性应激性反应 (acutestressreaction ,ASR)。目前截瘫患者心身健康程度显著低于对照组 ,表现在SCL -90中的总分和部分因子分 ,SDS总分和标准分 ,SAS总分和标准分 ,CMI中部分因子分均显著高于对照组 (P均 <0 0 1～ 0 0 0 1)。结论 :心理创伤的严重程度与人类的心身健康之间存在着密切的关系。     

Lessons from the 2015 earthquake(s) in Nepal: implication for rehabilitation

Purpose: There has been an increase in the number of natural disasters in recent history, and the rate of disability is increasing among survivors. The most recent major natural disaster was the earthquake(s) that occurred in Nepal on 25 April 2015 and 12 May 2015. In total, more than 8500 people were killed and over 18?500 people were left injured. This article aims to demonstrate the role of rehabilitation professionals in post-disaster relief and beyond in Nepal. Method: This is an experiential account of physiotherapists present during the earthquake and participating in the post-disaster relief. Results: Rehabilitation professionals played an important role in the acute phase post-disaster by providing essential services and equipment. However, discharge planning emerged as an important role for rehabilitation providers in the early days of post-disaster and signaled a relatively new and innovative function that facilitated the heavy imbalance between little supply and tremendous demand for care. In the coming years, rehabilitation will need to support local initiatives that focus on minimizing the long-term effects among people with a newly acquired disability. Conclusions: Rehabilitation serves an important role across the continuum in post-disaster relief from the initial stages to the months and years following an event.

• Implications for Rehabilitation

• Driven by medical advances in acute field medicine, the relative proportion of casualties following natural disasters is decreasing, while relative rates of disability are rising among survivors.

• In post-disaster settings, the growing number of people with newly acquired disabilities will be added to the existing proportion of the population who lived with disabilities, creating a significant growth in the total number of people with disabilities (PWDs) in communities that are often ill prepared to provide necessary services.

• Rehabilitation interventions in the initial stages of emergency humanitarian response can minimize the long-term effects among people with newly acquired disabilities through early activation and prevention of secondary effects.

• Rehabilitation providers thus appear to have an important mediating effect on outcomes of disabilities in the early stages, but must also be strong partners with PWDs to advocate for social and political change in the long term.