目的：探讨5·12汶川地震致脊髓损伤患者神经源膀胱的康复治疗方法。方法：通过对35例脊髓损伤患者神经源膀胱康复治疗的总结回顾，观察采用制定饮水计划，间歇性导尿，药物治疗，膀胱功能训练，手术治疗等方法治疗神经源膀胱的疗效。结果：经过综合治疗，35例患者的神经源膀胱都得到了不同程度的改善。结论：地震致脊髓损伤发生率高，而神经源膀胱是其重大并发症之一，危害患者生命，重建脊髓损伤后患者的膀胱功能对于提高截瘫患者的生活质量，降低死亡率具有十分重要的意义。
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
Shortly after the Wenchuan earthquake, we established headquarter of crisis intervention, which was responsible for reporting earthquake situation and training personnel to carry out psychological intervention and publicize earthquake-related knowledge. Then, urgent psychological intervention was provided to the target populations. We offered crisis intervention more than 100 times (40,000 person-times), provided individualized psychological services or therapies over 3,000 person-times and treated more than 200 patients with posttraumatic stress disorder. Meanwhile, we established relevant administration systems including registration, reporting, rapid screening and personnel work logs. Our preliminary survey conducted 1 month after the earthquake showed that the prevalence of posttraumatic stress disorder reached 43%. After the earthquake, the victims’ emotions of depression and anxiety were raised and the prevalence of posttraumatic stress disorder had a sharp increase. The victims’ requirements for psychological crisis intervention after earthquake were immense.
To retrospectively summarize the medical rescue organization and strategy of West China Hospital medical team during the Wenchuan earthquake so as to provide reference for rescue practice in the future. We emphasize that the key point to improve the efficiency of rescue is scientifically assigning and util izing medical resource according to the demand at the actual locale of the earthquake and the characters of various stages of the earthquake .
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.
摘要:在汶川地震救援中,华西医院门诊部作为医院的窗口、形象,地震发生当天迅速组织人员,沉着、冷静地疏散门诊附近万名患者及家属,无一例踩伤、摔伤;随着各种渠道转来医院的患者增多,为利于有效的管理与护理人力安排,在保证门诊正常工作开展的前提下,服从医院大局安排,抽调护理人员承担起每日到机场接送患者的任务及急诊注射室的工作,为地震伤员的及时转送与救治、处理作出了应有的贡献。
Objective To examine the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method, from June 12th to June 18th, we investigated the medical staffs in eight areas, and the total number was 500. The eight areas included Mianzhu, Deyang, Shifang, Chengdu, Mianyang, Pengzhou, Zitong, and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). After collecting all questionnaires, we divided 500 medical staffs into 2 groups, according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects, of which 481 effective ones were collected, and the effective rate was about 96.2%. In addition, the prevalence of PTSD for overall was 23.3%, anxiety was 21.6%, depression was 49.9%, and the anxiety plus depression was 19.54%. At the same time, we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03), PCL-C frequency (16.27±15.14 vs. 9.99±10.25), PCL-C severity (32.03±15.26 vs. 24.85±8.60), SAS primitive (37.39±10.35 vs. 32.22±7.61), SAS standard (46.73±12.94 vs. 40.27±9.51), SDS primitive (42.00±8.32 vs. 37.99±9.63), and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions, and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59), anxiety (28.89% vs. 12.32%), depression (58.15% vs. 39.34%), and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different, and the disaster area was under severe conditions. Additionally, the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD, SAS, and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore, we should work out mental intervention and rehabilitation project for medical staffs, especially those who took part in rescue in the disaster area. Finally, the medical staffs’ ability to copy with stress can be improved.
Objective To provide a disaster triage method by analyzing the data of the hospital transferring casualties after Wenchuan earthquake. Method The data of the patients’ admission and hospital transferring in the West China Hospital were collected after the earthquake in two weeks. Moreover, the reason and the method of the hospital transferring were analyzed. Result In the first two weeks since the earthquake struck Wenchuan, the number of the available bed for earthquake patients in West China Hospital was 124 per day, but in the 2 227 earthquake patients treated, 1 181 patients were admitted. Comparing with the number of the total hospitalized, the percentage is 53.03%. The hospital was overloaded. After a reasonable hospital transference, the daily number of inpatients was stable and all the patients were treated sufficiently. Conclusion After a natural disaster, an effective administration transferring patients to suitable medical recourse should be performed, so that more right treatments should be given to more right patients in the right time and right place.
Objective To summarize the experience of medical rescue conducted in Aba prefecture after the Wenchuan earthquake in order to provide information for similar tasks in seismo-active regions. Methods We participated and witnessed the whole process of medical rescue through 100 days after the quake. Data regarding the medical rescue work, work mode, performance and problems were collected and analyzed. Results Twelve counties out of the 13 counties in Aba prefecture were affected by the earthquake, including 2 most-hit counties and 5 most-hit areas. A total of 20 233 people died and 7 873 disappeared. Aba Prefectural Headquarters for Earthquake Resistance and Disaster Relief was set up and medical rescue teams were dispatched to the disaster area immediately after the quake: ① From May 12 to May 15 2008, 20 local medical teams comprising 138 healthcare professionals and 14 teams involving 428 professionals from other regions arrived at the most-hit areas. Through 7 days after the quake, medical treatment was provided for 6 285 patient-times. ② A total of 1 444 healthcare professionals participated in the medical rescue work. Through August 20, 355 579 outpatients and 7 028 inpatients were treated in the prefectural medical institutions and on-site medical centers. Of those, 6 726 were discharged, 604 were severely wounded, 20 died and 456 were transferred to other regions for further treatment. 2 703 operations were performed for the wounded and psychological treatment was provided for 4 630 person-times. Conclusion The medical rescue work in Aba prefecture after the Wenchuan earthquake was effective and efficient. Management of human resources and medical devices should be strengthened to enhance the ability of emergency response.