目的 探討老年髖部骨折圍手術期的治療策略。 方法 回顧性分析2004年1月-2009年1月手術治療的96例老年髖部骨折患者的臨床資料。 結果 術前81.25%(78/96)合并內科疾病的患者,均安全度過手術期。術后發生并發癥20例,發生率為20.83%。術前有并存疾病者手術治療優良率為84.61%,術前無并存疾病者手術治療優良率為94.44%;術前有無并存疾病患者的手術優良率比較,差異有統計學意義(Plt;0.05)。 結論 老年髖部骨折患者術前合并疾病較多,應視其個體情況,采取積極恰當的圍手術期處理,積極控制和治療合并疾病,才能降低圍手術期并發癥的發生率,取得優良的治療效果。
Objective To examine the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method, from June 12th to June 18th, we investigated the medical staffs in eight areas, and the total number was 500. The eight areas included Mianzhu, Deyang, Shifang, Chengdu, Mianyang, Pengzhou, Zitong, and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). After collecting all questionnaires, we divided 500 medical staffs into 2 groups, according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects, of which 481 effective ones were collected, and the effective rate was about 96.2%. In addition, the prevalence of PTSD for overall was 23.3%, anxiety was 21.6%, depression was 49.9%, and the anxiety plus depression was 19.54%. At the same time, we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03), PCL-C frequency (16.27±15.14 vs. 9.99±10.25), PCL-C severity (32.03±15.26 vs. 24.85±8.60), SAS primitive (37.39±10.35 vs. 32.22±7.61), SAS standard (46.73±12.94 vs. 40.27±9.51), SDS primitive (42.00±8.32 vs. 37.99±9.63), and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions, and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59), anxiety (28.89% vs. 12.32%), depression (58.15% vs. 39.34%), and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different, and the disaster area was under severe conditions. Additionally, the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD, SAS, and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore, we should work out mental intervention and rehabilitation project for medical staffs, especially those who took part in rescue in the disaster area. Finally, the medical staffs’ ability to copy with stress can be improved.
Objective To suggest the establishment a publication plan for emergency situations in order to better manage and control information to the outside environment based on the experience of front-line hospital of grade III level A in Deyang during the response to the Wenchuan earthquake. Method We systematically collected statistical information published in the forms of news, columns, newspapers, periodicals, statistics, brief massage sent out by China Telecom ans China Mobile and banners in various media (CCTV, Sichuan TV, and inside hospital etc.) after Wenchuan earthquake.Result Within 40 days after the Wenchuan Earthquake, the People’s Hospital of Deyang City had reported rescue information for 181 times, sent 1 600 000 phone messages to the public, issued 7 476 pieces of family-search information, distributed 1 486 earthquake first-aid brochures, distributed 1 750 psychological brochures, compiled 12 periodicals called “Special Report for Earthquake Relief Effort”, and finished 3 periodicals called “Special Issue for Earthquake Relief Effort”; issued 319 articles, over 200pictures and videos on websites inside and outside of the hospital; issued over 60 pieces of news and 7 special topic documentaries in CCTV etc.; and issued over 70 pieces of news on People’s Daily. Conclusion During the Wenchuan earthquake, the People’s Hospital of Deyang City shows the rescue work to the public via effective publication mechanisms. News and information is transmitted fast and effectively between people from both upper and lower levels. However, there are weaknesses in working mechanisms and methods, which requires further study and consideration.