摘要:目的: 了解绵竹市社区卫生服务系统震后现状,同时分析社区医疗震后居民满意度和社区卫生服务机构震后灾害干预能力,以期为社区卫生服务体系地震应急恢复和重建提供参考意见。 方法 :采用随机抽样的方法,抽取绵竹市剑南社区卫生服务中心和天河社区卫生服务中心进行访谈,采取方便抽样的方法,抽取24‰的绵竹城区居民采用面对面访谈的方式用自制问卷进行调查,并用Epidata30 进行数据录入、SPSS130进行统计分析。 结果 :共发放问卷240份,收回有效问卷229份(有效回收率954%)。当地社区卫生服务系统在地震中受损严重。社区卫生服务系统灾后工作居民满意度为454%,社区卫生服务机构对居民进行抗灾/防灾知识教育的比例为336%,灾后是否有持续而足够的常见病药品供应及是否有持续而足够的慢性病药品供应是影响当地居民对当地社区卫生服务体系灾害应急工作的满意度的影响因素(P 值分别是0033,0001)。 结论 :震后社区卫生服务居民满意度较低,服务体系地震灾害干预能力不足。居民在在灾前接受抗灾教育的比例较低,加强药品储备能提高社区卫生机构灾害应急工作的效果。在社区卫生服务体系重建的过程中,应注重社区医疗基础工作的恢复,基础设施的重建和健全社区急救体系。Abstract: Objective: To investigate the reality of community health service system after earthquake in Mianzhu, the satisfaction of community residents to the community health service as well as the postdisaster emergency response capability of community hospital in order to provide decisionmaking suggestions on better reconstruction of community health service system. Methods : Jiannan and Tianhe community hospital were randomly selected for visiting and 24‰ of community residents in the city zone of Mianzhu were selected by convenience sampling for a facetoface interview using a questionnaire. Data entry and statistically analysis were completed by Epidata30 and SPSS130 respectively. Results :A total of 240 questionnaires were conducted to facetoface interviews, and 229 questionnaires were returned (response rate 954%).The community health service system was badly injured. Residents’ satisfactory degree of the community health service after earthquake was 454%. The proportions of disaster / disaster prevention education was 336%,medicine supply for familiar diseases and the chronic were the main factors which influenced judgements of residents to the emergency response capabilities of community hospitals(〖WTBX〗P =0033,P=0001,respectively). Conclusion :The community health services after earthquake had not been widely satisfied and the emergency response capability of community hospital was far from enough. The proportions of disaster / disaster prevention education were far from enough. The effectiveness of emergency response work of community hospitals can be enhanced by reinforcing medicine preparation.In the course of the reconstruction, community health service system should pay attention to the resumance of basic community health service,reconstruction of basic establishment and construction of firstaid system.
目的:了解绵竹市社区卫生服务系统震后现状,同时分析社区医疗震后居民满意度和社区卫生服务机构震后灾害干预能力,以期为社区卫生服务体系地震应急恢复和重建提供参考意见。方法:采用随机抽样的方法,抽取绵竹市剑南社区卫生服务中心和天河社区卫生服务中心进行访谈,采取方便抽样的方法,抽取2.4‰的绵竹城区居民采用面对面访谈的方式用自制问卷进行调查,并用Epidata 3.0 进行数据录入、SPSS13.0进行统计分析。结果:共发放问卷240份,收回有效问卷229份(有效回收率95.4%)。当地社区卫生服务系统在地震中受损严重。社区卫生服务系统灾后工作居民满意度为45.4%,社区卫生服务机构对居民进行抗灾/防灾知识教育的比例为33.6%,灾后是否有持续而足够的常见病药品供应及是否有持续而足够的慢性病药品供应是影响当地居民对当地社区卫生服务体系灾害应急工作的满意度的影响因素(P值分别是0.033,0.001)。结论:震后社区卫生服务居民满意度较低,服务体系地震灾害干预能力不足。居民在在灾前接受抗灾教育的比例较低,加强药品储备能提高社区卫生机构灾害应急工作的效果。在社区卫生服务体系重建的过程中,应注重社区医疗基础工作的恢复,基础设施的重建和健全社区急救体系。
Objective To analyze retrospectively the overall situation of medical rescue in the Third People’s Hospital of Chengdu after the Wenchuan earthquake, so as to provide references for the emergency preparedness for the disaster of earthquake. Methods The analysis was based on the data provided by the Department of Information, the Medical Record Library, the Department of Emergency, the Department of Orthopaedics and other related departments of the Hospital up to 8 a.m. of July 12. The software of Microsoft EXCEL was used for data input, and SPSS 11.5 was used for statistical analysis. Results Up to July 12, 563 cases from the disaster area had been treated in the hospital, of whom 249 were admitted into the outpatient department and 314 into the inpatient department, including 287 men and 276 women, with a median age of 42 years (28, 57) in the outpatient department and a median age of 46 years (33, 65) in the inpatient department. The inpatients’ age was older than the outpatients’s (P=0.003). Most outpatients were sent to the hospital within the first 3 days after the quake (73.50%), while less than half of the inpatients were sent to the hospital during this period of time. The wounded were mainly from Dujiangyan, Aba Prefecture and Pengzhou, which was correlated with the transportation distance, the casualty and the condition of the local hospitals. The wounded were mainly admitted into the Departments of Orthopaedics (69.3%), Neurosurgery (15.6%) and General Surgery (3.7%). The total cost in the Department of Orthopaedics was the highest, followed by the Intensive Care Unit (ICU) and the Department of Neurosurgery. However, the median cost in the ICU was the highest, followed by the Department of Neurosurgery and the Department of Nephrology. Only 9 out of the 563 patients died, including 5 outpatients and 4 inpatients, of whom 8 deaths were due to craniocerebral injury and 1 died of crush syndrome. Conclusion Based on the data, it is of vital importance to develop an emergent plan for the medical rescue after an earthquake disaster, and to strengthen the reserve of medical supplies, personnel training, scientific field triage as well as the construction of information platforms.
Objective To retrospectively analyze medical treatment during the Wenchuan earthquake and evaluate emergency medical work. Methods On the basis of the data reported to the provincial disaster relief headquarter by cities and counties around Sichuan province, we established a database for data processing by using SPSS 11.0. And descriptive statistical analysis was performed. Results The emergency response of Sichuan health system was quick, effective and well-organized. Conclusion In the face of extraordinary disaster, Sichuan province satisfactorily completed its work on emergency medical treatment despite the unimaginable enormous workload and difficulty, and achieved an initial success on earthquake relief.
During the medical rescue of Wenchuan earthquake, West China Hospital immediately shifted to the two-track emergent system mode. More works have been done in time to cure and treat those critically ill patients effectively and to protect the medical safety of patients. The Activated Contingency Plans for major disasters have been started up to evacuate safely those mild patients in the hospital,to prevent out of danger and other accidents. More works have done on the identification of the injured or patients to improve the accuracy and strictly implement the "three investigations and seven right" system to prevent a wrong operation, or a wrong prescription, or a wrong transfusion. We have worked carefully on the referral the wounded, to referr the wounded to those Hospitals in Chengdu or other province and to prevent security incidents.
Objective To analyze the performance of epidemic prevention in Sichuan Province after Wenchuan earthquake, so as to provide references for future epidemic prevention when such emergencies occur. Methods Data about the relief work after the Wenchuan earthquake were collected from the archives of medical care assurance group of the anti-seismic and disaster relief headquarter. And then the data were classified and analyzed. Results After the Wenchuan earthquake, the strategies of epidemic prevention included emphasis on both epidemic prevention and medical relief, early implementation of hygienic measures, wide coverage of different measures for disease prevention with focuses on the most important diseases, as well as standardization and long lasting of epidemic prevention efforts. Owing to these strategies, the epidemic prevention in Sichuan Province was conducted vigorously, orderly and effectively. Conclusion The post-quake epidemic prevention strategies in Sichuan Province are accurate and effective, which could be recommended when such emergencies occur in the future.
摘要:目的:探讨地震伤员中膝关节损伤的机制、类型及处理方法。 方法:对我院收入住院的2728例 5·12汶川特大地震伤员伤情特点进行分析,筛选出有膝关节损伤的病例进行分析。 结果: 膝关节损伤前三位分别是髌骨骨折(42.15%)、胫骨平台骨折(21.05%)、股骨髁骨折(13.16%),这与人们在地震时奔跑摔伤以及被房屋倒塌砸伤有很大关系。结论:地震后膝关节损伤其发病率、受伤机制、损伤类型、合并伤情况及治疗处理均有其特点,总结这些特点和规律将对地震伤膝关节损伤患者的处理产生积极作用。Abstract: Objective: To investigate the knee joint injury mechanisms, types and treatment of the earthquake wounded. Methods: Analysis the characteristics of the 2728 cases of West China Hospital from 5.12 Wenchuan earthquake wound, screen out the cases of knee joint injury. Results: Patellar fracture (42.15%),tibial plateau fracture(21.05%), femoral condyle fracture (13.16%), were the top three of knee joint injuries, which have a great relationship with falling down and (or) injured by collapsed houses when people were running in the earthquake. Conclusion: After the earthquake the knee joint damages its disease incidence rate, is injured the mechanism, the damage type, the merge wound situation and treatment processing has its characteristic, will summarize these characteristics and the rule damages patient’s processing to the earthquake wound knee joint to have the positive role.
Shortly after the disastrous Wenchuan earthquake, a harmonious working environment for healthcare professionals both at home and abroad has been formed in West China Hospital, under an integrated managerial framework and working model. Four foreign medical teams consisting of over 70 professionals and foreign medical materials weighing about 8 tons have been accepted. This model may provide references for the reception of foreign medical teams during the emergent medical rescue for any unexpected event in the future.
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients. Method From May 14th to June 24th, the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded. Owing to correctly treating the wound and screening the skeptical gas gangrene patients, preventing nosocomial infections was shifted forward. Sprending the gas gangrene wound after having flushed it with 3% H2O2. If the wound have been stitched, the stitches should bee taken out, and open the wound and take the debridement for it completely, then treat it with b antibacterial after debridement by sterilization and isolation about operation of gas gangrene. Result Up to June 24th, none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard. At present, amomg the 67 cases, 32 were highly suspected of gas gangrene infection, 26 cases were discharged, while 6 cases were undergoing treatment in the hospital. Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.