海上医疗队平时海上灾害医学救援的效果研究

目的通过分析海上医疗队（组）在海上展开灾害医疗救援的效果,探讨提高海上灾害医学援救能力。方法2003年1月～2009年12月期间,海上医疗队以10～15、50和120人的编组构成与展开流程的实践回顾,全组经海上医疗救护97批次,抢救伤病员1257例,对伤病员进行分类,现场急救、急救手术、海水浸泡伤的综合处理和快速后送。结果本组1257例伤病员中,存活1183例（94％）,死亡74例（6％）,其中伤后1h以内21例（28％）,24h以内51例（69％）;死于创伤68例（92％）,溺水3例（4％）,中毒伤员3例（3％）。结论通过海上医疗队在平时海上灾害时医疗救援的展开实践,提高了海上灾害救援的快速反应能力、整体配合能力和救援水平,丰富了海上医疗队的救援经验。     

Impacts of disasters: comparisons of several worries in Turkey

The aim of this paper is to define respondents' levels of worries and to find out the main predictors of each worry factor by comparing the results of earthquake (2001) and bird flu (2006) studies carried out in Turkey. Assuming that the critical power‐conflict perspective was appropriate; several types of worries, namely, traffic accidents, natural disasters, unemployment, health and sickness, nuclear plants, war and terrorism, and environmental problems defined by Kamano have been analysed using parametric and non‐parametric statistical significance tests. The results revealed that earthquake hazards affected respondents' level of worries more than bird flu disease mainly because of the enormous economic and human losses of the 1999 earthquake. It was also found that the main predictors were not the same for both studies: the education variable was more effective on the level of worries of earthquake survivors, and gender was more influential for the bird flu study. Copyright © 2008 John Wiley & Sons, Ltd.     

Short communication: patterns of chronic and acute diseases after natural disasters - a study from the International Committee of the Red Cross field hospital in Banda Aceh after the 2004 Indian Ocean tsunami

Objective To assess the pattern of diseases in a natural disaster, which are not necessarily a direct consequence of the event but can impact on the way health assistance is to be provided. Methods Cross‐sectional, record‐based study in the International Committee of the Red Cross field hospital in Aceh, Indonesia, established immediately after the tsunami in 2004. Patients who presented to hospital from January 15 to 31, and whose diagnoses were available, were included in the study. Results One thousand one hundred and eighty‐eight residents of Aceh participated. 43.5% of the diagnoses was chronic diseases. The odds of chronic vs. acute diseases increased by 16.4% per day up to January 23 [95% confidence interval (CI): 7.8–25.6%] and decreased thereafter by 13.1% (95% CI: 6.6–19.1%) per day. The odds of acute diseases were 34% lower among females than males (95% CI: 16–49%) and 4.3 times higher among children than the rest of the population (95% CI: 2.4–7.6). There were relatively few trauma cases among females and children. Conclusions Medical teams providing relief after acute disasters should be prepared to provide healthcare for chronic diseases too. A delay in the presentation of many acute conditions has implications for long‐term health consequences of disasters, such as disability.     

构架灾害事故的紧急医疗救援体系

我国四川成都灾害事故医疗救援模式在全国众多医疗救援运行模式中采取加强急救医疗网络建设;装备医疗急救系统,着重人才培养;制定结合本地实际的救灾医疗预案、组织演习;提高现场灾害事故紧急医疗救援品质;普及急救知识、危机意识,做好“第一目击者”的培训,独具特色。构架灾害事故紧急医疗救援体系,并与当地政府、医疗、公安、消防、军队等密切配合,很好地完成日常院前急救和突发灾害事故的医疗紧急救援。     

地震救援高海拔空投时机体的反应与对策

2008年5月12日14:28,四川省汶川发生8.0级特大地震,造成重大生命和财产损失.面对突如其来的罕见灾难,空军迅速投入大量兵力全面展开救援工作,震后灾区道路阻隔,桥梁坍塌,空投和空降一度成为了保障救援物资送达地震中心区域的重要手段.灾区地形条件极为复杂,加之高原气候变幻无常,执行空投任务异常艰巨.5月17日,空军首次在海拔5400 m高空实施空投作业时,空投员因高空缺氧严重,导致执行任务中断,后经采取一系列措施,最终完成了空投任务.现报道如下:     

脊椎地震伤的影像诊断价值

目的：探讨脊椎地震伤的影像诊断价值。方法：回顾性分析22例脊椎地震伤的影像学及临床资料，22例患者均行X线检查，20例行CT检查，15例行MRI检查。结果：影像学检查均能明确诊断，脊椎压缩骨折20例，爆裂性骨折2例。单发椎体骨折12例，多发椎体骨折10例，共累及31个椎体。31个椎体骨折中，颈椎3个，胸椎12个，腰椎14个，骶椎2个。结论：影像学检查有利于脊椎地震伤的及时准确诊断和治疗方式的选择。     

International Emergency Medicine: A Review of the Literature from 2006

The field of international emergency medicine (IEM) has grown rapidly over the past several decades, with a rise in the number of IEM fellowship positions, sustained growth in the international sections of major emergency medicine organizations, and an increase in the range of topics included under its rubric. One of the greatest obstacles to the continued growth of IEM remains the lack of a high-quality, consolidated, and easily accessible evidence base of literature. In response to this perceived need, members of the Emergency Medicine Residents' Association IEM Committee, in conjunction with members of the Society for Academic Emergency Medicine International Health Interest Group, embarked on the task of creating a recurring review of IEM literature. This article reviews 25 IEM research articles published in 2006. Research articles were selected for the review according to explicit, predetermined criteria that included both methodological quality and perceived impact of the research. It is the authors' hope that this annual review will act as a forum for disseminating best practices while also stimulating further research in the field of IEM.     

地震伤患者创面鲍曼/溶血不动杆菌定植与感染的研究

目的 研究地震伤患者创面鲍曼/溶血不动杆菌定植和感染的临床特点,探索其诊治对策. 方法 选择"5.12"汶川地震后收治的376例开放性损伤患者中42例创而鲍曼/溶血不动杆菌培养阳性患者进行回顾性分析,其中男24例,女18例;年龄12～96岁,平均37岁.开放性损伤部位:上臂1例,前臂4例,大腿12例,小腿23例,躯干2例.伤后到就诊入院时间3～7 d.了解其临床特点并做细菌鉴定和药物敏感试验,对比分析其对15种抗生素的耐药性. 结果 本组地震伤患者中创而鲍曼/溶血不动杆菌定植31例,发生率为8.2%;创面鲍曼/溶血不动杆菌感染11例,发生率为2.9%.经清创、早期预防性抗生素使用、营养支持,15例细菌定植患者均行Ⅱ期缝合或创面植皮,16例创面培养阴性后转外省治疗;经扩创引流、全身敏感抗生素使用、全身营养支持,11例感染患者中有6例创面感染控制,Ⅱ期消火创面,4例患者出现肺部感染,1例患者出现败血症.创面检出的42株鲍曼/溶血小动杆菌药敏结果 中,对亚胺硫霉素最为敏感,敏感率为59.5%;对丁胺卡那、左氧氟沙星、替卡西林/棒酸、妥布霉素较为敏感,敏感率分别为21.4%、21.4%、19.5%、19.0%. 结论 地震伤患者创丽鲍曼/溶血不动杆菌感染的危险因素有:组织创伤重、伤口污染重、伤后到获得初次救治间隔时间长、机体抵抗力弱.在诊疗上应注意区分细菌定植和细菌感染的不同临床特点,重视创面正确处理、抗生素合理使用和增加机体抵抗力,可提高临床治愈率.