“7.23'温州动车事故伤员伤情特点及救治分析

摘要

Objective To analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience. Methods A total of 177 cases who were injured or died in the "7.23" Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause. Conclusions The causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.%目的 总结并分析“7.23”温州动车事故伤员伤情特点,探索救治经验. 方法 以“7.23”温州动车事故生存和死亡伤员共177例为研究对象,分析伤员的年龄、性别、致伤原因、损伤部位、损伤严重程度等信息,并输入由第三军医大学中华创伤数据库中心研制的创伤数据库系统V3.0进行评分和分析. 结果 事故后24 h内共收治伤员137例,男76例,女61例,性别差异无统计学意义；其中生存136例,救治无效死亡1例；撞击伤、挤压伤及重物坠落砸伤是主要的致伤原因；生存伤员中,多发伤108例(79.4％)；所有生存多发伤伤员中,以胸部、头部和四肢分列为第一、第二和第三位常见受伤部位；TI分值最小5分,最大27分.TI分值≤9分4例(3.7％),10 ～ 16分86例(79.6％),≥17分18例(16.7％).ISS＜ 16分的伤员78例(72.2％),ISS≥16分的伤员30例(27.8％),其中ISS分值最小3分,最大75分.共死亡40例(包括入院后救治无效死亡1例),死亡伤员均为多发伤,颅脑损伤为第1位死亡原因. 结论 本次动车追尾事故伤因复杂,多发伤发生率高；损伤程度不一,但总体情况较轻；常见损伤部位分布在生存伤员和死亡伤员中存在显著差异；应根据这些伤情特点采取有针对性的现场检伤分类、逐级转运、专科救治.