汶川地震1周年救援官兵心理应激状况及危险因素分析

目的调查汶川地震1周年救援官兵创伤后应激障碍(post traumatic stress disorder,PTSD)的现患率并探讨其危险因素。方法采用晤谈法和自编一般情况问卷、PTSD症状清单平民版(PTSD Checklist-Civilian Version,PCL-C)、简易应对方式问卷(simple coping style questionnaire,SCSQ)、症状自评量表(SCL-90)和艾森克个性问卷(eysenck personality questionnaire,EPQ)的部分因子组成调查表,于汶川地震1周年时对1176名救援官兵进行调查。结果1周年后救援官兵PTSD现患率为3.45%,PCL-C各症状因子均分<2分;SCL-90中躯体化因子分显著高于军人常模(P<0.01),抑郁、焦虑因子分显著低于军人常模(P<0.01);EPQ中神经质(N)因子分显著低于军人常模(P<0.01),内外向(E)因子分显著高于军人常模(P<0.05);SCSQ中积极应对因子分显著高于中国陆军常模(P<0.01),消极应对因子分显著低于中国陆军常模(P<0.01);不同救援单位军人在PTSD总分、再体验...     

四川汶川地震伤情统计与分析

目的研究四川汶川地震所致伤员的伤情特点和规律。方法对我院收治患者进行登记，采用国际疾病分类方法（ICD-10）统计、分析其损伤的外部因素、疾病分类及构成情况。结果本组患者主要损伤外部原因为被物体击中和被物体挤压。疾病构成前5位为：胫腓骨骨折158例（13．37％），骨盆骨折122例（10．32％），脊柱骨折120例（10．15％），股骨骨折109例（9．22％），前臂骨折／脱位106例（8．97％）。结论深入研究地震所致伤员的伤情特点，对合理使用、调配医疗资源，更好地为灾民提供医疗服务有重要的指导意义。     

地震伤员严重下肢挤压伤保肢治疗体会

目的 探讨地震伤员严重肢体挤压伤的保肢治疗.方法 在不干扰批量伤员救治的前提下,通过严格掌握纳入指征,合理配置医疗人员,按照分级救治程序,对伤员进行紧急救治和早期处理,特别重视监护调整脏器功能,一旦出现无法控制的生命体征紊乱即行截肢,病情稳定后及时后送.结果 1例肾功能损害加重再次手术截肢,9例均成功存活.至后送时,8例保肢伤员肢端血管搏动有力,毛细血管充盈时间正常,初期保肢成功率达88.9%.结论 依托良好的人员配置、ICU监护下脏器功能调整和科学的分级救治程序,部分严重挤压伤患者可以避免截肢.     

汶川地震中医院住院伤病员的营养干预

在汶川地震医疗救援中,华西医院营养科通过调整标准食谱、制订特殊饮食处方,为住院地震伤病员提供安全卫生的营养膳食,在此基础上再以整蛋白非要素膳为补充以满足伤病员对营养的需求;为危重、不能经口进食的伤病员提供个体化的全肠内营养支持方案并实施全肠内营养支持治疗;对住院伤病员进行营养宣教等一系列营养干预措施,不仅满足地震伤病员基本的营养需求,同时还为其疾病康复打下了坚实的基础。     

汶川地震救援官兵适应不良与社会支持的相关性

目的探讨抗震救援官兵适应不良与社会支持及相关因素的关系，并观察对其实施干预的效果。方法随机抽取146名参加救援官兵和165名非救援官兵进行军人适应不良自评量表和社会支持量表调查，并对发生适应不良者进行相应的心理干预或药物治疗。结果抗震救援组军人适应不良自评量表总分及其各因子分均高于非抗震救援组（P〈0．05）。抗震救援组军人适应不良自评量表总分与社会支持量表总分之间呈负相关（r=-0．43，P〈0．01），即获得的社会支持越少，适应不良的发生率越高。影响抗震救援官兵适应不良的主要影响因素是社会支持和婚姻状况；心理和药物干预具有明显的效果，使99．3％出现适应不良的官兵中有93．1％的心理障碍者完全缓解。结论参加抗震救援官兵出现明显的适应不良，而良好的社会支持和有效的干预措施，可减少适应不良的发生。     

浅谈汶川地震腹部损伤

The character, classification, scoring, diagnosis and treatment of abdominal injuries after the Wenchuan earthquake were analyzed based on the data collected in Chengdu and Dujiangyan. Most of the abdominal injuries were closed injury, and complicated with injuries in other organs. All the injured persons were classified into different groups according to the degree of injuries, so as to determine the optimal sequence of treatment. Open abdominal injuries were comparatively easy to diagnose, while the diagnosis of closed abdominal injuries was difficult and consisted of preoperative diagnosis and intraoperatire exploration. The principle of damage control surgery should be well followed in rescuing the persons with severe abdominal injuries.     

震区四肢骨折病人感染的后方治疗

目的 讨论震区后送四肢骨折并感染病人的治疗.方法 回顾性分析我科收治的19例震区四肢骨折并发感染患者的治疗经验,研究其治疗的方法和时机.结果 19例伤员感染均得到有效控制,平均时间15天,无新截肢及残端超关节修整病例.结论 震区四肢骨折伤员感染发病率高,特殊感染机会大,应正确、积极控制感染,减轻患者痛苦.     

汶川地震德阳市腹部损伤的调查与分析

A magnitude of 8.0 earthquake struck on Wenchuan on May 12, 2008. Until July 1, 1393 injured persons had been admitted to Deyang People's Hospital. Of all injured persons, 32 were diagnosed with abdominal injury, including 18 men and 14 women. All the abdominal injuries were closed injury, and multiple abdominal viscera were involved in the abdominal injuries after the earthquake. Careful examination is crucial in preventing missed diagnosis. The incidences of the liver and spleen injuries were significantly higher than that of the intestine, and the reason may be that the liver and spleen are the parenchymal viscera. Diagnostic abdominocentesis can timely diagnose the parenchymal viscera with severe blood loss. Diagnostic peritoneal lavage combined with selective CT scan can timely diagnose the abdominal injuries with comparatively low cost.     

汶川地震后德阳极重灾区预防性消毒工作调查分析

目的通过现场调查汶川地震极重灾区德阳部分乡镇灾后预防性消毒情况，为灾后卫生防疫指挥和现场工作预案提供依据？方法采用方便抽样方法，使用报表资料和自制的“德阳市地震灾后防病措施阶段性工作消杀灭评估表”现场调查德阳灾区25个乡镇的107个村、17个灾民安置点的消毒剂种类、来源、消毒培训情况、消毒范围和面积等。结果消毒剂（当地采购4％、国家调拨89．5％、社会捐赠6．5％）种类繁多，规格包装不一。由各级CDC对参加预防性消毒的所有防保人员和88％的受灾地区居民进行消毒技术培训后完成预防性消毒工作。极重灾区、重灾区和城区预防性消毒比率递减。截至震后第38天总消毒覆盖面积为986553316m^2，极重灾区绵竹占85．09％，约为其非森林覆盖幅员面积的1．26倍。结论应急状态下正确选定消毒对象、合理组织消毒、有效培训消毒人员，完善消毒剂储备、调拨、运输和审计机制，远比消毒技术本身更有现实和长远意义。     

Effects of a major earthquake on blood donor types and infectious diseases marker rates

This observational study attempted to identify the effect of a natural disaster on the safety of blood supply and donor types with the influx of donors after a severe earthquake. Blood donation rate, blood discard rate and safety of blood donations responding to the earthquake, as projected from the infectious disease marker rate, were evaluated in blood donated immediately before (1 July-17 August) and after 17 August 1999 (17 August-21 August). These were compared with the results from the corresponding periods in 1998 and 2000 for donations at a university medical centre and two regional blood centres. 8055 units of allogeneic blood were collected at two regional blood centres, and 450 units were collected at a university medical centre during 4 days. Viral marker rates were nearly the same at the former but were slightly lower at the latter. The blood discard rate was nearly twice the comparative periods at the former, but it remained unchanged at the latter. Voluntary donors replaced the replacement donors during 4 days. This analysis highlights the size of the pool of potential donors that are available as a national resource that can be motivated to give blood with the right motivation.