目的:了解地震住院伤员的身心状态,进行针对性心理干预。方法:采用方便抽样,应用作者根据应激理论设计的应激身心反应调查表［1］,通过对地震伤员的观察和访谈,对在2008年5月12日至5月30日在四川大学华西医院住院的371名地震伤员进行身心状态的评估,并进行有针对性的心理干预。结果:①地震伤员灾后急性期心身应激反应较严重,其中出现频率最多的症状是睡眠困难,对突然的噪音或声音感到紧张害怕,心情沮丧,感到身体紧张,心情难以平静;②不同性别地震伤员身心反应存在一定差异,女性反应症状重于男性;③年龄在小于12岁、12～18岁和41～50岁年龄段地震伤员的身心反应与其他年龄段地震伤员的身心反应存在差异;④地震伤员的身心反应与其性别、年龄、文化、个人受伤情况有关。结论:地震伤员灾后身心反应严重,急性期给予针对性心理干预十分重要。
目的：研究四川汶川大地震骨折伤员的日常生活活动（ADL）能力受限的特点，为地震骨折伤员的康复治疗提供依据。方法：对因2008年5月12日四川汶川地震后1月仍在华西医院骨科病房诊治的36例骨折伤员，进行生活状况问卷，记录其早期并发症，根据Barthel指数评定不同性别和不同部位骨折伤员各项ADL能力，统计伤员各项ADL等级构成比，比较不同性别和不同部位骨折伤员总ADL评分。结果：本次地震骨折伤员以下肢骨折多见，其次是躯干骨折（主要是脊柱骨折），上肢骨折相对少见；且ADL下降明显，尤其是躯干骨折和下肢骨折伤员；而早期并发症以伤口感染为主。结论：地震骨折伤员ADL明显下降，加强ADL能力训练尤其重要，临床康复措施主要集中于下肢和脊柱骨折的康复；早期并发症的防治主要是预防伤口感染。
Objective To elucidate the effect of first-aid fast track in triaging earthquake trauma patients by studying the earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” so as to accumulate experience in the treatment of disaster traumas. Methods A retrospective study was done on earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” from 14:28 May 12, 2008 to 14:27 May 15, 2008. Differences in care given during the time period were analyzed. Results There were 536 earthquake trauma patients in West China Hospital within 72 hours after the earthquake. Twohundred and seven earthquake trauma patients staying in the Emergency Department had an average stay of 129 minutes during the 24 hours after the quake; 104 earthquake trauma patients staying in the Emergency Department had an average stay of 97 minutes in the second 24 hours; and 226 earthquake trauma patients staying in the Emergency Department had an average stay of 86 minutes in the third 24 hours. Each consecutive day showed shorter average stays. Conclusion The first-aid fast track not only guarantees earthquake trauma patients are saved as soon as possible but also shortens the time in the Emergency Department.
ObjectiveTo carry out an investigation on the life quality of amputees in the “5·12” Wenchuan earthquake before and after rehabilitation of one year (short term), three year (intermediate term) and five year (long term) and find out the best program of recovery. MethodsIn September 2008, 52 patients who were treated in the higher-level hospital and came back to the Second People’s Hospital of Mianzhu City for rehabilitation were divided into two groups: group A and B with 26 patients in each. Phased rehabilitation program was adopted for group A while traditional program was chosen for patients in group B. “The Personal Information Table of Amputees of Deyang City” and The Life Quality Measurement Table of World Health Organization were chosen as the research tools before the program and one year, three years and five years after the program. ResultScores of the life quality of both groups showed a general rising tendency, while group A was higher than group B in each single phase, especially in the longterm one. For positive feeling, group A got a score of 193.0±12.3 and group B got 126.0±11.2; for ability to work, group A had a score of 62.0±5.2 and group B had 41.0±2.3; for life satisfaction, group A achieved 150.0±2.1 and group B achieved 101.0±6.2; for ability of action, the score of group A was 17.0±2.6 and group B was 11.0±5.2. The differences were statistically significant (P ＜ 0.05) . ConclusionCompared with conventional rehabilitation program, phased rehabilitation program can better enhance and consolidate the amputees’ quality of life and promote their returning to family and society, which can make up for the deficiency of the existing rehabilitation programs and is worth popularization and application.
Objective To explore the traumatic situation and transfer methods of the in-patients injured in Lushan Earthquake, and to provide evidence for treating injured mass in future. Methods The information of the patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital were collected by “No. 1 Military Medical Project” hospital information system and a self-edited “Questionnaire for Hospitalized Patients Injured in 4.20 Lushan Earthquake”. Results A total of 65 patients were admitted in this hospital: 63 (96.92%) patients were injured in the main shock; 28 (43.08%) patients were injured by building collapse; 23 (35.38%) patients got injured due to falls or got bruised when escaping; and 14 (21.54%) patients were accidentally injured. Rescue methods: 32 (49.23%) patients were saved by themselves; 23 (35.38%) patients were mutually helped; 10 (15.38%) patients were rescued by local non-military rescue team; 34 (52.31%) patients were rescued by military rescue teams; and 26 (44.83%) patients were transferred by air transport. Conclusion In order to cope with emergencies and major disasters (e.g. earthquake) and to treat injured mass scientifically in the future, we should set up emergency wards scientifically and reasonably, carry out education on earthquake prevention and disaster mitigation widely, reinforce self-care and mutual aid in the stricken area, quickly send rescue and medical teams, and organize training for air transportation of patients.
Objective To discuss the mode of triage patient in Emergency Department of West China Hospital of Sichuan University after the Wenchuan earthquake and the major experience during the process. Method The patients’ severity level of injury and waiting time for medical care in Emergency Department were analyzed after earthquake in 2 weeks. Result 375 patients were triaged into the severity level and get the treatment followed the triage systems gave the highest rate of survival and lowest rate of over triage and under triage. Conclusion In the calamity of Wenchuan earthquake with large number of casualties, Emergency Department automatically shifted into disaster mode and triage victims by the irregular triage systems. In this situation, medical staff do not just triage the patients to the Emergency Department or to see a doctor, but triage the victims to the medical care immediately and efficiently. By the new triage system, the West China Hospital saves more lives in less time.
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.