汶川地震后部分地区耳鼻咽喉头面部伤情调查与分析

目的 调查分析强烈地震灾害造成的耳鼻咽喉头面部的伤情及救治.方法 对2008年5月12日四川汶川地震后第二军医大学医疗队所在安县、茂县、江油县及汶川县三江镇收治的、及巡诊的受伤人数进行调查,重点对伤员的耳鼻咽喉、颌面及头颈部的伤情、致伤原因、救治方法进行分析.结果 本组患者为地震3 d后存活人群中的耳鼻咽喉头面部伤227例,多是轻伤或伴有复合伤,其中185例头面部软组织伤,13例鼻骨或鼻窦骨折,18例鼻出血,7例颅底骨折,4例耳廓撕裂伤.根据救护所及医院的不同医疗条件进行诊断和治疗,对软组织损伤采用清创换药缝合,骨折尽可能复位.对伴有复合伤的危重伤员急救稳定后送至有条件的医院进一步治疗.救护所救治的46例中除3例复合伤或可疑视神经损伤的重伤员后送外,43例5～10 d痊愈.医院救治181例中除3例有颅底骨折的复合伤转院后送外,住院31例至5月26日痊愈出院26例,留院治疗的5例均为复合伤未愈者;147例未留院患者中除1例耳廓撕裂伤感染再次清创延期愈合外,146例软组织伤痊愈并拆,骨折患者在愈合中,未见并发症.结论 对地震后的耳鼻咽喉头面部伤应尽早清创缝合、骨折复位,注意合理用药,危重伤员及时后送,可以减少并发症的发生,降低死亡率.

Investigation and analysis on Wenchuan area earthquake trauma to ear,nose and throat

Objective The epidemic data of Wenchuan area earthquake trauma of ear,noge and throat were investigated.Methods Affected families and sufferers of part of disaster area in Sichuan province in 2008 were investigated with emphasis on severity,cause and treatment of otorhinolaryngologic trauma.Results Two hundred and twenty-seven cases of otorhinolaryngologic trauma in survival crowd 3 days after earthquake were ineluded in this study.Most of them were minor trauma or complex lesion.There were 185 cases of soft tissue wound in head and face,13 cases of fracture of the nose,18 cases of hemorrhage of the nose.7 cases of fracture of the skull base,4 cases of lacerated wound of the auricle.Diagnosis and numagement were carried out by medical aid post and field ambulance on different condition.The methods of treatment included debridement and suture of soft tissue wound and positioning of fracture.If there was serious injury and accompanied complex lesion,the patients should be sent to hospital after emergent treatment.Forty-six cases were treated in medical aid post,except 3 cases of complex lesion by transportation,43 cases recovered in 5 to 10 days after treatment.One hundred and eighty-one cases were treated in field ambulance,except 3 cases with fracture of skull base by transportation.Among 31 hospitalized patients,26 recovered and were discharged before 26th of may,5 were still in ward because of complex lesion.Among 147 cases treated out of wards with soft tissue wound,146 cases recovered and bone fracture in rehabilitation.1 case of lacerated wound of auricle was infected with delayed healing.There were no complication in all cases.Conclusions For earthquake trauma of the ear,noge and throat,emergent management are debridement,suture and positioning of fracture.For seriously iujured patient,transportation to hospital in time can decrease complications and death rate.