汶川大地震医疗转运上万灾区伤员“进出成都”的救援学特征
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摘要
目的总结强震期间灾区伤员医疗救援大转运的专业特点。方法查阅120中心抗震救灾调度指令的派车记录和伤员转运的值班统计,收集全市120网络等各医疗机构震灾救援的官方信息,结合120中心应急反应的具体行动等进行归纳分析。结果经120中心统一调度指挥,震后4周内共救援转运灾区伤员8264人进入成都市内住院救治,转出2431人至外省进一步治疗。入城伤员中,震后头3d为救援高峰期,占86.30%(7132/8264);重伤员约占总数比例13%;院内死亡伤员中,90.54%(134/148)发生在震后第一阶段;各阶段住院死亡率随救援进程加大呈现下降趋势(2.07%~0.77%)。陆路转运成都周边灾区伤员数量最大,占81.53%(6738/8264),用时13d;空路转运重灾偏远山区伤员数量居次,占16.50%(1363/8264),但耗时最长(24d);水路转运周期最短(4d)。出城伤员中,第三阶段为转运高峰(53.56%),单日伤员最大出城量专列大于包机。结论汶川大地震医疗转运灾区伤员具有转运周期长、转运高峰短、重伤员偏多、死亡时段集中等独特的救援学时间特征、伤情特征、路径特征等,对未来的震灾救援具有启示作用。
Objective To sum up the professional characteristics of medical transportation of the wounded in the disaster areas after Wenchuan earthquake. Method To consult on-duty statistics including the transportation of the wounded and the records of the vehicle in 120 center. To collect and analyze the official information of the rescue of earthquake disaster in the city's network of 120 hospitals, and combined with the specific actions of 120 center emergency reaction. Result By 120 center centralized dispatch and direction, within 4 weeks after the earthquake, 8264 wounded people of the disaster areas were transported into Chengdu, 2431 people were transported to other provinces for the further treatment. The first 3 days post-earthquake was the peak of rescue, the wounded accounted for 86.30% (7132/8264); severely injured cases was about 13% of the total; 90.54% (134/148) of the wounded died in hospital occurred at the first stage after the earthquake; the mortality of various stages in hospital showed a downwards with the rescue process(2.07%~0.77%). The quantity of the wounded around Chengdu area transported by land route was the biggest (81.53%, 6738/8264), the days of transportation were 13 days. The quantity of the wounded in the out-of-the-way mountainous area were transported by the air road accounted for 16.50% (1363/8264), but time-consuming was the longest about 24 days. The water-way was the shortest transit cycle (4 days).In the wounded going out of the town, the peak of transportation (53.56%) was at the third stage. The quantity of largest single-day wounded cases going out of town by train was bigger than those by the charter airplane. Conclusion The characteristics of medical transportation of the wounded in Wenchuan earthquake was long transit cycle, short transit peak, more severely injured cases, the centralized death time section, and so on, will have the enlightenment for the rescue of future earthquake disaster.
Objective To sum up the professional characteristics of medical transportation of the wounded in the disaster areas after Wenchuan earthquake. Method To consult on-duty statistics including the transportation of the wounded and the records of the vehicle in 120 center. To collect and analyze the official information of the rescue of earthquake disaster in the city's network of 120 hospitals, and combined with the specific actions of 120 center emergency reaction. Result By 120 center centralized dispatch and direction, within 4 weeks after the earthquake, 8264 wounded people of the disaster areas were transported into Chengdu, 2431 people were transported to other provinces for the further treatment. The first 3 days post-earthquake was the peak of rescue, the wounded accounted for 86.30% (7132/8264); severely injured cases was about 13% of the total; 90.54% (134/148) of the wounded died in hospital occurred at the first stage after the earthquake; the mortality of various stages in hospital showed a downwards with the rescue process(2.07%~0.77%). The quantity of the wounded around Chengdu area transported by land route was the biggest (81.53%, 6738/8264), the days of transportation were 13 days. The quantity of the wounded in the out-of-the-way mountainous area were transported by the air road accounted for 16.50% (1363/8264), but time-consuming was the longest about 24 days. The water-way was the shortest transit cycle (4 days).In the wounded going out of the town, the peak of transportation (53.56%) was at the third stage. The quantity of largest single-day wounded cases going out of town by train was bigger than those by the charter airplane. Conclusion The characteristics of medical transportation of the wounded in Wenchuan earthquake was long transit cycle, short transit peak, more severely injured cases, the centralized death time section, and so on, will have the enlightenment for the rescue of future earthquake disaster.
引文
1石应康,郑尚维.区域性国家级医院在汶川地震医疗救援中的战略支撑作用[J].中国循证医学,2008,8(6):380-382.
2刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学,2006,15(12):1063-1066.
3胡卫建.四川汶川地震紧急医疗救援的思考.四川省抗震救灾紧急医疗救援学术研讨会大会发言稿.成都,2008.07.12.
2刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学,2006,15(12):1063-1066.
3胡卫建.四川汶川地震紧急医疗救援的思考.四川省抗震救灾紧急医疗救援学术研讨会大会发言稿.成都,2008.07.12.
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