ObjectiveTo analyze injury sites and radiologic features of 60 patients with severe earthquake trauma in Min-Zhang earthquake in 2013. MethodsWe retrospectively collected clinical data of 60 patients with severe earthquake trauma who were sent to major hospitals in Lanzhou city within 7 days after the earthquake. The software of Excel was used to input and analyze clinical data. ResultsAmong 60 patients with severe earthquake trauma, there were 20 cases with single-site injury and 40 cases with multi-site injury, amounting to 120 injury sites. A total of 41 cases were injured in the limbs, involving 53 parts of fracture, of which, 11 cases were injured in the upper limbs (12 sites) and 34 cases in the lower limbs (41 sites). A total of 14 cases were injured in the skull (16 sites). 13 cases were injured in the spine involving a total of 14 vertebrae, 20 sites, of which, 10 cases were accompanied by injuries in the brain and spinal cord. A total of 17 cases were injured in the chest, of which 6 cases were accompanied by rib fracture, amounting to 27 sites. A total of 7 cases were accompanied by visceral injury, involving four sites of the abdomen. ConclusionMulti-site and multi-organ injuries are the most after the earthquake, of which, limb fracture is frequently-seen and abdominal injuries are rare. Imaging examination is very useful in screening injuries caused by the earthquake and in treatment based on categorization.
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.
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.
Objective To analyze the injury characteristics and the rescue process and effects for the victims admitted in the People’s Hospital of Deyang City within 72 hours after 4.20 Lushan earthquake, so as to discuss how to adopt the emergency program to implement medical rescue in disaster relief. Methods The data of 25 earthquake victims admitted in the hospital from April 20th, 2013 to April 23rd, 2013 were collected to analyze age, gender, the location of injury, the injury state of different age groups, and the prognosis of victims. Results Of the 25 victims with injuries on 32 locations of the body, there were 20 cases with single injury (80.00%) and 5 cases with multiple injuries (20.00%). Most injuries were seen in four limbs, body surface, and soft tissues; and the incidence of single injury was higher than that of multiple injuries. The number of admitted victims was largest on the first day after earthquake, accounted for 92.00%, which was obviously higher than that on the second and the third day. Victims aged from 19 to 45 years old was more than those of other ages. Conclusion Scientific emergency command system and disaster emergency program play an high-efficient command role in disaster rescue, shorten the time of emergency response, and improve the ability of disaster rescue. The comprehensive capacity of self-rescue and well-organized rescue for disaster area can be improved as long as the general public is educated about the disaster emergency program and cooperative emergency drill. Meanwhile, smooth traffic and unobstructed communication are guaranteed in the disaster area, and the cooperative efforts are made by all walks of society.
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.
目的 分析汶川大地震伤员的放射学表现特点。 方法 收集2008年5•12汶川大地震发生后至5月31日间213例地震伤员的完整放射学资料，着重分析伤员的X线、CT、MRI检查的影像学表现特点。 结果 213例中，同时行X线、CT、MRI检查10例（5%），X线、MRI检查7例（3%），X线、CT检查9例（4%），仅行CT检查5例（2%），仅行X线检查182例（85%）。MRI检查17例（8%）中，同时行胸椎和腰椎检查2例、颈椎和胸椎1例，颈椎1例，膝关节2例，上腹部1例，骨盆1例，腰椎9例；CT检查24例（11%）中，头部9例，胸部6例，腹部1例，脊柱6例，骨盆2例；X线检查208例中，单部位检查64例（31%），多部位检查144例（69%），仅有软组织受伤38例（18%），单纯肺挫伤6例（3%），骨折164例（79%）。 结论 地震伤员影像学检查以常规X线为主，头颅、五官受伤者首选CT，CT、MRI检查作为胸部、脊柱、关节等部位的补充检查。地震伤员以单纯性骨折为主，骨折合并脏器外伤较少。
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。
目的:通过对地震伤患儿家属心理状态的分析及心里疏导,探讨地震伤患儿家属心理干预的方法.方法:对我科2008年5月12日后收治的116例地震伤患儿家属的心理状态进行分析,并给与相应的心理干预。结果:116例地震伤患儿及家属心态良好,积极配合救治和护理,无心理障碍引起的过激反应,护理满意度达99%。结论:对患儿家属积极有效地进行心理疏导,不仅可以减轻其心理压力,还可以缩短与患儿及家属间的距离,有助于医护人员对患儿进行诊疗与护理,促使患儿早日康复。