Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios. Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.? Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples. Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
Objective To discuss the treatment of craniocerebral injuries caused by earthquake. Methods Retrospective analysis of clinical information for 256 patients with craniocerebral injury caused by an earthquake. Results The ‘Classification and Treatment’ was applied to the patients, whether or not they were operated on. A total of 146 patients were cured, 68 improved, 24 remained dependent on the care of others, and 8 died. The mortality rate was 3.13%. Conclusion Applying the ‘Classification and Treatment’ to patients with craniocerebral injury following an earthquake supported the use of medical resources and was associated with a low rate of death and disability.
目的:总结汶川地震损伤院内急救护理的特点,探讨灾害事件中急诊护士蕴藏的救援能力及今后灾害护理学应关注及建设规范的任务及课题。方法:通过对2118例地震损伤伤员的护理救护活动进行分析、总结经验。结果:根据院内救治地震损伤例数数量排前几位的依次分为开放性伤口851例、闭合性伤口809例、多发伤322例、伤口感染86例、气性坏疽32例、肢体离断伤18例、死亡2例。结论:灾害损伤与急救护理密不可分。灾害应急护理是一个需要探索、重视、实践长期建设规划的任务及课题.
目的 总结大型灾害情况下，急诊伤员信息收集流程，为制定大型灾害救援提供证据支持。 方法 回顾性分析汶川地震（2008年5月12日－6月2日）和玉树地震（2010年4月14日－5月1日）伤员信息收集方法，总结两次地震伤员信息收集管理过程中发现的问题及取得的经验。 结果 通过制作地震伤员登记表、调整病历收集与管理模式、分诊提前、伤员信息登记提前，调整急诊功能分区、头像采集技术的使用、成批伤员信息资料袋和分诊信息卡的应用，最大限度地保证了伤员信息收集的完整性。 结论 地震伤员信息资料的准确性、完整性、及时性在伤员的救治、伤员的查找、伤员的转归和各类医疗信息的收集，以及制定大型灾害事故应急预案等方面起着非常重要的作用。
目的:探讨磁共振血管造影(MRA)以及计算机断层扫描血管成像(CTA)对地震挤压伤下肢血管病变的临床价值。方法:对5·12汶川大地震中我院收治的已确诊为地震挤压伤致双下肢横纹肌溶解症3例患者进行双下肢MRA检查,并对严重挤压伤及下肢毁损,并行截肢的另三名患者进行术后CTA检查。对MRA图象双下肢动脉进行回顾性分析,总结MRA征象,同时总结截肢术后患者CTA表现及临床价值,并评价二者检查在挤压伤所至横纹肌溶解症的临床诊治中的作用。结果:3例未行截肢患者MRA双下肢主要动脉未见确切狭窄及闭塞征象,管腔内未见充盈缺损影。3例已行截肢患者可见残余肢体的明显肿胀,双侧髂血管以及部分截断肢体远端血管内见止血弹簧钢圈影像,部分截断肢体远端动脉分支变细。截断血管未见再通,周围无渗血改变。结论:MRA、CTA能直观显示双下肢动脉损伤及术后情况,在临床应用中各有优势和局限性。对二者的合理选择能为临床诊治提供有利信息。
ObjectiveTo summarize the nursing experience of vacuum-assisted closure (VAC) technology for deficiency of skin and soft tissue in "4·20" earthquake damage. MethodsWe used VAC to treat 20 patients suffering from deficiency of skin and soft tissue who were injured in "4·20" earthquake (35 wounds) from April 21st to 28th, 2013; and we observed closely the results of nursing for pain and psychological care. ResultsA total of 35 wounds were all cleaned after 5 to 7 days; 20 wounds were healed after VAC treatment; 15 wounds recovered well by covering autogenous split-thickness skin; 20 patients had stable emotion and all left the hospital with the recovery. ConclusionVAC for deficiency of skin and soft tissue caused by "4·20" earthquake damage may obviously decrease the time of wound healing, relieve the pain caused by changing fresh dressing, and reduce the length of stay in the hospital.
ObjectiveTo explore the possible association between early injury assessment indexes and the length of stay (LOS) in first-line hospitals, in order to help the hospitals take advantage of resource effectively and transfer victims reasonably during earthquakes. MethodWe retrospectively analyzed the medical information of 3 576 traumatic patients injured in the Wenchuan Earthquake who were transferred to 242 first-line medical institutes between 14:28, May 12th and 14:30, May 19th in 2008. Three kinds of 15 variables were extracted for the analysis, including gender, age, heart or lung disease, pre-hospital time, head injury, trunk injury, open injury, crush injury, asphyxia, body temperature, heart rate, respiration, systolic blood pressure, diastolic blood pressure, and Glasgow coma score. Multiple stepwise linear regression analysis was performed to identify the factors associated with LOS. ResultsThe multiple linear regression analysis showed that age as well as other six factors affected LOS significantly (P<0.05). The partial regression coefficients of age, pre-hospital time, head injury, trunk injury, crush injury, complication of cardiac or pulmonary disease, and Glasgow coma score were -0.062, 0.157, 3.703, 4.111, 12.602, 14.762 and -1.312, respectively. ConclusionsEarthquake trauma patients with older age, long pre-hospital time, head injury, trunk injury, heart or lung disease, crush injury, and lower Glasgow coma score are at increased risk for extended LOS.
目的 观察社区康复护理对地震伤截瘫患者的疗效。 方法 2008年12月－2009年6月，选取都江堰市多家医院共87例康复期地震伤截瘫患者，其中观察组选取在社区采取康复护理措施的患者，对照组选取在住院期间进行健康宣教和出院时按常规进行出院指导的患者，比较两组研究对象的日常生活活动能力、并发症发生率和治疗效果。 结果 观察组日常生活活动能力优于对照组（F=8.042，P=0.009），并发症发生率低于对照组（泌尿系统感染：χ2=6.464，P=0.011），治疗效果优于对照组（U=598.500，P=0.001）。 结论 社区康复护理有利于改善地震伤截瘫患者的日常生活活动能力并预防并发症，对提高患者的生存质量有着十分重要的意义。
【摘要】 目的 探讨汶川大地震伤员胸部外伤的影像学表现特点。 方法 对2008年5月12日-6月21日因地震胸部外伤在我院放射科检查的687例患者（年龄1～96岁）的临床资料进行回顾性分析。将患者按10岁为一个年龄组划分。所有患者均行胸部X线片检查，38例行CT检查。 结果 687例患者中，256例检查结果为阳性，阳性率为37.26%。年龄以30~79岁年龄组为主。在阳性伤员中，98例（38.28%）为多系统多发伤，159例（62.11%）为多种类型胸部伤同时存在，肋骨骨折198例（约77.34%），肺挫裂伤49例(约19.14%)。 结论 本组地震伤员多系统多发伤、多类型胸部伤常见，肋骨骨折及肺挫裂伤为主要损伤表现。影像学检查有助于胸部外伤的及时和准确诊断。【Abstract】 Objective To explore the imaging features of thoracic trauma in patients injured in Wenchuan earthquake. Methods The radiological data of 687 patients (aged from 1 to 96 years) with thoracic trauma who underwent radiological examinations between 12 May and 21 June 2008 were retrospectively analyzed. The patients were divided into subgroups according to the age. All patients underwent X-ray plain film examination, in whom 38 underwent CT examination. Results In 687 patients, the results of the examination were positive in 256 with a positive rate of 37.26%; the major injured patients were in the 30-79 years old group. In the patients with positive findings, 98 (38.28%) were accompanied by multi-system injuries, 159 (62.11%) were comprised of several types of thoracic trauma. There were 198 patients (about 77.34%) with rib fracture and 49 patients (19.14%) with lung contusion. Conclusions Multi-system injuries and several types of thoracic trauma are common in the patients injured in the earchquake. The main traumatic manifestations are rib facture and lung contusion. Imaging examination is very helpful in the diagnosis of thoracic trauma.