摘要目的 调查杭州燃爆事故现场救援及伤员情况,为类似群体性伤亡事件的应急医疗救援提供数据支持. 方法 由2位具有一定临床经验的医务人员至杭州市120急救中心收集2017年7月21日事故当天现场救援情况的相关资料,如事故当天急救车辆出诊、现场指挥及交通、现场检伤分诊分流情况.再至事故伤员就诊的医疗机构调查伤员情况,包括伤员一般资料(伤员的性别、年龄、收治医院以及事故发生2周内的出入院、转诊情况等)、伤情评估[致伤部位、致伤类型,采用新损伤严重程度评分表(NISS)评估受伤严重程度,另评估烧伤严重程度]等. 结果 (1)共有15辆急救车辆参与现场救援,现场交通极为混乱、堵塞,现场检伤分类难以有效开展.(2)本次调查共收集到53例伤员资料,其中男24例、女29例,年龄8～70(34±14)岁,收治在杭州市的6家医疗机构.2例伤员于事故当天死亡.截至事故发生后2周,共有28例(52.8％)伤员出院,门诊随访治疗;医院间转诊5例,均为伤情严重伤员.(3)根据NISS评分,伤员中轻度29例(54.7％)、中度9例(17.0％)、重度3例(5.7％)、特重度12例(22.6％).其中2例死亡伤员的NISS评分记为75分,归入特重度.本组伤员最常见致伤类型均为皮肤软组织损伤.6例(11.3％)伤员合并烧伤.按照烧伤严重程度分类,轻度1例、重度1例、特重度4例. 结论 杭州燃爆事故伤员众多、伤情复杂;当地应急医学救援响应迅速,但现场救援的诸多方面仍有较大提升空间.

abstractsObjective To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou,so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty.Methods Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July,2017,including ambulance call-outs,on-site command and traffic conditions,and on-site triage and evacuation of the victims.They were then sent to the hospitals receiving the victims to investigate the situations of these victims including the general information (such as gender,age,admitted hospitals,and number of admission,discharge,and transferring in the first two weeks after the accident) and injury assessment [such as injury position and type,injury severity evaluation by New Injury Severity Scoring (NISS),and burn severity evaluation for victims with burns].Results (1) A total of 15 ambulances reached the accident site for rescue.The traffic and transportation were jammed and interrupted after this accident.Onsite triage and distribution were disorderly conducted.(2) Clinical data of 53 victims were collected,including 24 males and 29 females,with the age of 8 to 70 (34 ± 14) years old.They were sent into 6 hospitals in Hangzhou.Two victims died on the day of accident.Up to two weeks after this accident,28 (52.8％)victims were discharged from the hospitals and received follow-up in outpatient department.Five victims with severe injuries were transferred to the other hospitals.(3) Based on the results of NISS,the injury severities were mild in 29 (54.7％) cases,moderate in 9 (17.0％) cases,serious in 3 (5.7％) cases,and severe in 12 (22.6％) cases.Those 2 dead victims were classified into the severe category due to the highest NISS score of 75.For all of the victims,skin and soft tissue defects were most common.Six (11.3％) victims were combined with burns.According to the classification of burn severity,there were one case of mild,one case of serious,and 4 cases of severe.Conclusions The gas explosion accident in Hangzhou caused massive casualties with complex injuries.The local emergency medical rescue responded quickly,but during the rescue process,lots of aspects should be further improved.