【摘要】目的对一线临床科室参与汶川地震抗震救灾的外援护士和本土护士的社会支持系统进行调查研究。方法随机抽取抗震救灾一线科室(ICU、骨科、急诊)外援护士及本土护士各175名,设为外援组和本土组,采用对地震的自我认知问卷及社会支持评定量表(SSRS)进行测评。结果两组护士对地震相关知识的知晓情况、响应抗震救灾的行为表现、地震对专业的影响等方面无明显差异(Pgt;0.05);两组护士的社会支持总分均低于国内常模 (Plt;0.01),除外援组主观支持维度得分与国内常模无显著差异(Pgt;0.05)外,两组的社会支持其它各维度得分均低于国内常模,外援组的社会支持总分及主观支持、客观支持得分均高于本土组(Plt;0.01),两组对支持的利用度无明显差异(Pgt;0.05)。结论为抗震救灾一线科室护士提供积极的社会支持是保证心理健康的重要措施。【Abstract】ObjectiveTo evaluate the difference of psychological state between local and nonlocal nurses during the Wenchuan Earthquake. Methods A total of 175 local nurses and 175 nonlocal nurses were randomly selected and investigated by SSRS and the earthquake questionnaire. Results There were no significant differences in their knowledge about the earthquake, professional identity and action (Pgt;0.05). The total and the three dimensions scores of SSRS of the two groups were lower than those of the domestic norms (Plt;0.01) except the subjective support dimensions. The total scores, objective support and subjective support dimensions scores of nonlocal group were higher than that in the local group (Plt;0.01). In coping style questionaire, there were significant differences in solving problems and retreat factor(Plt;0.01)and no significant differences in remorse, salvation and illusion(Pgt;0.05). Conclusion The earthquake affected mental health of the nurses and their psychological state need to be much concerned,especially the nonlocal ones.
Objective To investigate the efficacy of interdisciplinary therapy in critically ill patients with gas gangrene in the 2008 W enchuan earthquake．Methods Four critically wounded patients with gas gangrene caused by Wenchuan earthquake were treated by interdisciplinary cooperation．Results Two patients received debridement and decompression were not amputated．Two amputated patients did not received futher amputation．Conclusions Interdisciplinary therapy of critically ill patients with gasgangrene in earthquake could limited the area of tissue necrosis，minimized the necessity of amputation and further amputation．
ObjectiveTo explore the relationship between severity of gastrointestinal symptoms and psychological stress after the earthquake. MethodsThe sample was teachers from Baoxing county which was most affected by the earthquake. Post-traumatic stress disorder checklist civilian version (PCL-C) scale was used to assess the symptoms of psychological stress at 2-3 weeks, 2-3 months, and 6 months after the earthquake, and gastrointestinal symptoms were evaluated using three questions of patient health questionare (PHQ)-15 at 2-3 months and 6 months after the earthquake. Spearman rank correlation was used to explore the dynamic relationship between the symptoms of psychological stress evaluated at the three waves and gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake. ResultsPrevalence rates of gastrointestinal symptoms in teachers were 6.7% and 4.7% for stomach and abdominal pain, 6.7% and 5.6% for constipation and diarrhea, and 9.1% and 8.1% for nausea and gastrointestinal flatulence or dyspepsia at 2-3 months and 6 months after the earthquake. The relationships between three gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake and psychological stress symptoms evaluated at the three waves were all significant (all P<0.05). ConclusionGastrointestinal symptoms are common among the teachers. The association between psychological stress symptoms and severity of gastrointestinal symptoms at the same point after the earthquake is most strong, and psychological stress symptoms in the early period can predict the severity of subsequent gastrointestinal symptoms, and gastrointestinal symptoms in the early period can predict symptoms of subsequent psychological stress.
A 7.1-magnitude earthquake hit china again, 702 days after Wenchuan Earthquake at Yushu prefecture of Qinghai province, 4000 meters above sea level. Up to April 19th, the death toll climbed to 1706, with 256 missing and 12128 injured. West China Hospital, as a regional state-level hospital of Ministry of Health, organized the first batch of medical team with relief supplies at the first day after Yushu earthquake and rushed to Yushu taking part into the rescue effort in golden seventy-two hours. The second day after Yushu earthquake, medical apparatus and drugs valued 5,000,000 RMB were delivered to the rescue site and the second batch of medical team were positioned. Within thirty three hours after the earthquake, 102 people, including 93 earthquake related injuries and 9 armed police with severe altitude illness, were sent to our hospital by air in four batches successively. Based on the first-hand experience of medical rescue in Wenchuan Earthquake, a series of diagnosis and treatment criteria which were built and developed with evidence-based method, and “four concentration principles”, namely concentrating the wounded, concentrating the experts, concentrating resources, and concentrating treatments, our medical rescue in Yushu earthquake were carried out appropriately. Up to 12 am., April 19th, 93 cases from the disaster area have been treated, of whom 54 seriously wounded, 58 underwent operations and none death. The experience learnt from Wenchuan Earthquake have been used, improved and sublimated more rapidly, more appropriately, more effectively in the Yushu earthquake medical rescue.
This article introduces the emergent measures and approaches that West China Hospital has taken to ensure the supply of water, electricity, gas and oxygen during the May 12th Wenchuan earthquake.
Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.
Shortly after Wenchuan earthquake, the leader group of the West China Second Hospital accurately defined the role of the hospital during the medical rescue work and ensured the safety of the inpatients. It cooperated with West China Hospital, going to the main battlefield to rescue the injured people, congregating the main medical resources to the disaster areas for medical rescue. The model of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of the resources were ensured to meet the ever-changing demands from all levels of rescue work. Assembling the elite, 12 medical teams and 148 medical staff in all were dispatched to Beichuan, Mianyang, Shifang and Dujiangyan as well as other severe disaster areas. Up to June 2nd, 329 patients from the disaster area had been treated, of whom 132 were admitted into the inpatient department, no one died. Moreover, even during such a period of time, the routine medical service had been offered as regular to patients other than the wounded in the disaster.
Objective To investigate the injury types, dysfunction situation and rehabilitation deamnd of the Lushan earthquake victims. Methods The rehabilitation demand of 208 Lushan earthquake victims in the West China Hospital of Sichuan University were investigated using a questionnaire. Results Bone fractures accounted for the largest proportion of injury types, followed by combined injuries, soft tissue injuries, pulmonary contusion, and amputation. Most victims suffered from the motor dysfunction, balance disorder and restrictions in activities of daily living. More than 80% of victims had pain. A few victims had paresthesia and respiratory disorder. Most victims needed rehabilitation assistant devices and hospitalization treatment. Conclusion The injury types and dysfunction situation of Lushan earthquake victims are associated with the demand of rehabilitation assistant device. The tailored rehabilitation regimen can be made in combination with victim’s rehabilitation demand. The early intervention of rehabilitation medicine is extremely beneficial to the recovery of earthquake victims.
Baoxing airborne medical team of West China Hospital participated in the medical rescue in 2013 “4?20”Lushan earthquake. The medical team excellently fulfilled their rescue task for 1 week in the earthquake-struck areas where there was power and communication failure and lack of water and food supply. We found some experiences and problems in airbornemedical team assembly and member selection, which may provide quotable experiences for future disaster assistance and rescue teams.
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.