目的分析汶川地震灾后伤病员疾病谱变化, 探讨医疗救援力量阶梯化配置方案。方法 按照WHO灾难医学管理指南中的灾后疾病分类法, 将伤病数据进行归类, 选出患病率前四名的伤病种;将四所参与地震救援医院的疾病谱按照1周、1个月、1个月以上为时间周期进行分类统计。结果 震后1周以外伤类疾病为主, 占全部的85.84%～95.42%;震后1个月内科疾病增多, 以急性呼吸道感染流行为主, 占全部患病的58.87%～65.27%;震后1个月以上, 外伤患者基本稳定, 以轻伤为主, 呼吸道疾病进入平台期, 消化道疾病伴随出现;皮肤类疾病散发于整个救援时期。结论 四所参与地震救援医院收治伤病员疾病谱随时间变化趋势不同, 震后早期应以外科专业医护救援人员为主, 中期则应做好内外科专业人员搭配比例的统筹, 晚期要注重传染病监控, 流行病学调查工作。

Objective To analyze the regularity of the disease specprum in injury patients after the Wenchuan earthquake. Methods According to classification of the diseases from the WHO’s Guide of Disaster Medical Administration, the injury data were sorted out and the prevalence of top four injuries were chosen, and classification and statistics were made by the period. Results The main disease was trauma and wounds in a week. In a month the medical diseases increased gradually, particularly acute upper respiratory tract infection. After a month, the trauma diseases declined and the respiratory illness got into a smooth period, accompanied by the diseases of the digestive system. Skin diseases occurred in the whole time. Conclusions Surgery was principal in the early stage after earthquake. The proportion between physicians and surgeons should be coordinated in the mid-time. In the later period, attention should be paid to prevent outbreak of the infectious diseases, and make a study of epidemiological investigation.