目的:了解地震中的不同經歷(即自己是否受傷,是否目睹他人受傷、死亡和房屋垮塌)與災區初中生災后一月抑郁問題的關系。方法: 地震發生后一月在災區某初級中學校隨機選取初一到初三的學生共1382人進行一般情況、地震經歷相關情況及DSRSC問卷調查。根據受試者有無以上經歷將DSRSC量表得分分為兩組。用SPSS11.5統計軟件對數據進行分析。結果: 受傷者與未受傷者震后一月DSRSC評分存在差異(P=0.001),受傷者重于未受傷者;目睹他人受傷者與未目睹他人受傷者震后一月DSRSC評分存在差異(P=0.005),目睹他人受傷者重于未目睹他人受傷者;目睹他人死亡者與未目睹他人死亡者震后一月DSRSC評分無差異(P=0.061);目睹房屋垮塌與未目睹房屋垮塌者震后一月DSRSC評分無差異(P=0.498)。結論:地震中不同經歷對初中生災后出現的抑郁問題有不同影響,因此對有不同經歷者進行針對性的干預有利于減少災后嚴重心理衛生問題的出現。
【摘要】目的對一線臨床科室參與汶川地震抗震救災的外援護士和本土護士的社會支持系統進行調查研究。方法隨機抽取抗震救災一線科室(ICU、骨科、急診)外援護士及本土護士各175名,設為外援組和本土組,采用對地震的自我認知問卷及社會支持評定量表(SSRS)進行測評。結果兩組護士對地震相關知識的知曉情況、響應抗震救災的行為表現、地震對專業的影響等方面無明顯差異(Pgt;0.05);兩組護士的社會支持總分均低于國內常模 (Plt;0.01),除外援組主觀支持維度得分與國內常模無顯著差異(Pgt;0.05)外,兩組的社會支持其它各維度得分均低于國內常模,外援組的社會支持總分及主觀支持、客觀支持得分均高于本土組(Plt;0.01),兩組對支持的利用度無明顯差異(Pgt;0.05)。結論為抗震救災一線科室護士提供積極的社會支持是保證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.
目的:探討四川汶川地震腹部損傷傷員CT表現及其診斷價值。方法:對我院因汶川地震受傷,需做腹部CT的傷員27例的治療,進行CT分析。結果:在本組腹部損傷傷員中, 肝臟病變7例,膽囊病變2例,胰腺病變11例,脾臟病變8例,腎臟病變11例,腹腔積液6例,腹腔積氣9例,胃腸道病變8例,子宮病變1例。部分傷員為兩個或兩個以上器官受累。結論: CT檢查結合臨床治療能快速、準確、有效的對地震腹部損傷傷員進行判斷,對臨床診治具有重要作用。
摘要:目的: 了解綿竹市社區衛生服務系統震后現狀,同時分析社區醫療震后居民滿意度和社區衛生服務機構震后災害干預能力,以期為社區衛生服務體系地震應急恢復和重建提供參考意見。 方法 :采用隨機抽樣的方法,抽取綿竹市劍南社區衛生服務中心和天河社區衛生服務中心進行訪談,采取方便抽樣的方法,抽取24‰的綿竹城區居民采用面對面訪談的方式用自制問卷進行調查,并用Epidata30 進行數據錄入、SPSS130進行統計分析。 結果 :共發放問卷240份,收回有效問卷229份(有效回收率954%)。當地社區衛生服務系統在地震中受損嚴重。社區衛生服務系統災后工作居民滿意度為454%,社區衛生服務機構對居民進行抗災/防災知識教育的比例為336%,災后是否有持續而足夠的常見病藥品供應及是否有持續而足夠的慢性病藥品供應是影響當地居民對當地社區衛生服務體系災害應急工作的滿意度的影響因素(P 值分別是0033,0001)。 結論 :震后社區衛生服務居民滿意度較低,服務體系地震災害干預能力不足。居民在在災前接受抗災教育的比例較低,加強藥品儲備能提高社區衛生機構災害應急工作的效果。在社區衛生服務體系重建的過程中,應注重社區醫療基礎工作的恢復,基礎設施的重建和健全社區急救體系。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:總結汶川大地震期間合并有多發傷的脊柱骨折的臨床特點和治療經驗。方法:回顧分析汶川大地震期間四川大學華西醫院收治的281例脊柱骨折,其中223例合并有多發傷,分析其臨床特點和治療方式。結果:223例合并多發傷的脊柱骨折中單純椎體骨折138例,單純附件損傷37例,椎體+附件骨折48例;平均年齡43.45±14.05歲;椎體分布以下胸段和腰段為主,胸腰段占60%左右;致傷原因中砸傷占82.1%;脊柱手術治療35例,占需手術治療的27.8%;合并傷共267例次;嚴重并發癥127例次;合并脊髓或馬尾神經損傷101例,占45.3%,有15例在搬運中發生脊髓損傷。結論:汶川大地震發生在山區,地震烈度高,傷員多為復合傷,存在嚴重的并發癥,受累椎體多,治療的重點首先放在處理開放傷、感染、并發癥上,影響了脊柱骨折的治療;早期救援時正確施救才能有效防范繼發性脊髓損傷。
The Wenchuan Earthquake caused severe injuries and deaths as well as subsequent serious potential risks to public health and hygiene in the worst-hit areas. There were 16 casualties in the Mianyang CDC system and the township amp; county CDC networks were destroyed in the worst-hit counties after the earthquake. The Mianyang CDC quickly launched its emergency response plan for major natural disasters within two hours after the earthquake, prepared and improved the technical guide for disease prevention after the earthquake and rapidly sent out quick response team. With the help of CDC aid teams across the country, Mianyang CDC successfully disinfected and buried 6,767,568 corpses, and disposed of millions of animal carcasses.They also disinfected and sterilised an area of 932.595 million square metres, eradicating 3,514,166 fly and mosquito breeding places and treating 5,254,228 cesspit times. By June 30, they had examined 11,092 water supply units and carried out disinfection of 319.7997 million cubic metres of drinking water. Besides, dynamic monitoring for water quality in the four worst-hit areas in Mianyang urban areas. They organised hygienic enforcement supervisors to develop food safety inspection, regulated catering services of the centralised settlements, destroyed spoiled and expired food and vegetables. The authorities prevented the masses from eating dead poultry or meat from carcasses to ensure no occurrence of food poisoning after the earthquake. Standard administration of the 170 settlements of the earthquake-afflicted people and 132 settlements of evacuated people was carried out in accordance with the rules of "Six Provisions and Four Reinforcements" and this would ensure no recurrence of public health events in the settlements. On Day 3 (May 15) after the earthquake, they established a real-time monitoring and report network of the epidemic situation after the earthquake and monitored diseases and symptoms of the people in the resettled region to ensure no occurrence of major epidemic cases. The monitoring results showed that the number of infectious disease cases was comparable to that in the previous years. Moreover, they carried out intensive vaccination with hepatitis A vaccine in children 41196 person times, stored 100,000 person oral cholera vaccine and monitoring for new sexually transmitted diseases. A total of 10.1265 million copies of publicity materials were organised printed and distributed. They developed large-scale health education and a massive patriotic health campaign by means of the media and organised the masses to engage in sanitation and hygiene as well as controlling flies, mosquitoes and rats in the temporary earthquake-proof places. Under the unified command of the Mianyang emergency response headquarters, the centers for health and epidemic control and prevention at various levels of disaster relief continued to dispose of carcasses and disinfect and bury corpses as well as monitor water quality, so as to ensure the secondary disasters could be prevented in advance.
目的:觀察康復訓練結合電針療法綜合治療汶川地震傷員四肢骨折術后關節活動度、肢體腫脹等功能障礙的療效。方法: 將126例患者分為治療組63例,采用康復訓練結合電針療法;對照組63例,于術后第2天自行功能鍛煉。測量治療前后關節活動度(ROM)、肢體腫脹消退時間及疼痛減輕程度并據此確定療效。結果: 用統計學方法處理,說明兩組之間ROM、肢體腫脹消退時間及疼痛減輕程度比較均有統計學意義(Plt;0.05)。結論: 采用康復訓練結合電針能有效提高地震傷員四肢骨折后關節功能障礙的療效。