汶川地震四川伤员康复措施及成效分析
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摘要
目的了解汶川地震伤员躯体康复现状。方法回顾性分析四川省卫生厅医政处工作档案资料,收集汶川地震伤员需康复治疗者的资料,采用ISS评分法评定伤员骨折伤情严重程度,用EXCEL软件建立数据库,对结果进行描述性分析。结果康复治疗分析结果显示,截至2009年2月5日,全省接受规范康复治疗28008例中27080例经一期康复治疗先后出院,出院率97.8%;全省仍有928人住院,需后续康复治疗,包括:颅脑损伤55例;截瘫伤员163例,截肢伤员约260例,脊柱、骨盆等骨折的重伤员449例。部分截肢患者需更换假肢或再次行残端修整手术及再康复;大部分安装内固定的伤员需取出内固定物及后期康复。结论由于各级政府重视,组织行之有效,汶川地震伤员康复工作成绩显著。今后应:①继续完善全省康复机构建设,增加资金投入;②加大医疗康复从业人员培训,提高业务水平及服务能力;③制定伤员后期康复标准,跟进随访及功能训练,使其功能达到最大程度恢复回归社会;④政府和社会应着力解决伤残人员就业问题。
Objective To investigate the recovery status of people wounded in the Wenchuan earthquake.Method Data were retrospectively collected from administrative documents in the Bureau of Medical Affairs,Sichuan Provincial Health Department.The severity of injury was assessed by Injury Severity Score(ISS).The data were recorded by EXCEL software and descriptive analysis was conducted.Results Our analysis results of rehabilitation treatment through Feb.5,2009 shows that 27,080 of the 28,008 patients had been treated and discharged,for a discharge rate of 97.8%.There were 928 patients still in hospitals at that time,including 55 cases of traumatic brain injury,163 cases of paraplegia,260 amputees,and 449 cases of severe spine,pelvis and other fractures.Some amputees needed to receive replacement of artificial limbs or stump dressing operation and rehabilitation;most patients who were installed internal fixation needed to removal and post-rehabilitation.Conclusions The effectiveness of rehabilitation is significant.Our work in the next stage should focus on(1) continuing to improve the establishment of province's rehabilitation capabilities and increasing capital investment;(2) enhancing training for medical rehabilitation practitioners in order to improve operational standards and service capabilities;(3) developing the wounded rehabilitation standards in later stages,conducting follow-up and functional training in order to maximize recovery and return to society;(4) increasing employment opportunities for disabled persons.
Objective To investigate the recovery status of people wounded in the Wenchuan earthquake.Method Data were retrospectively collected from administrative documents in the Bureau of Medical Affairs,Sichuan Provincial Health Department.The severity of injury was assessed by Injury Severity Score(ISS).The data were recorded by EXCEL software and descriptive analysis was conducted.Results Our analysis results of rehabilitation treatment through Feb.5,2009 shows that 27,080 of the 28,008 patients had been treated and discharged,for a discharge rate of 97.8%.There were 928 patients still in hospitals at that time,including 55 cases of traumatic brain injury,163 cases of paraplegia,260 amputees,and 449 cases of severe spine,pelvis and other fractures.Some amputees needed to receive replacement of artificial limbs or stump dressing operation and rehabilitation;most patients who were installed internal fixation needed to removal and post-rehabilitation.Conclusions The effectiveness of rehabilitation is significant.Our work in the next stage should focus on(1) continuing to improve the establishment of province's rehabilitation capabilities and increasing capital investment;(2) enhancing training for medical rehabilitation practitioners in order to improve operational standards and service capabilities;(3) developing the wounded rehabilitation standards in later stages,conducting follow-up and functional training in order to maximize recovery and return to society;(4) increasing employment opportunities for disabled persons.
引文
18月12日四川汶川地震抗震救灾进展情况.http://www.gxcic.net/news/shownews_69788.html.
2Baker SP,O Neill B,Haddon W,et al.The injury severity score:a method for describing patients with multiple injuries and evaluatingemergency care.J Trauma,1974,14:187-196.
3周志道.创伤评分的现状和展望.中华创伤杂志,1994,10:30.
4陈维庭.医院内创伤严重度评分法AIS-ISS法.中华创伤杂志,1994,10:44-46.
5Gans BM.Creating the future of physical medicine and rehabilitation buiding on our past.Arch Phys Med Rehabil,2003,84(7):946-949.
2Baker SP,O Neill B,Haddon W,et al.The injury severity score:a method for describing patients with multiple injuries and evaluatingemergency care.J Trauma,1974,14:187-196.
3周志道.创伤评分的现状和展望.中华创伤杂志,1994,10:30.
4陈维庭.医院内创伤严重度评分法AIS-ISS法.中华创伤杂志,1994,10:44-46.
5Gans BM.Creating the future of physical medicine and rehabilitation buiding on our past.Arch Phys Med Rehabil,2003,84(7):946-949.
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