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【medical-news】汇012 巴基斯坦地震脊髓损伤康复
Spinal cord injury management and rehabilitation: highlights and shortcomings from the 2005 earthquake in Pakistan.
Rathore FA, Farooq F, Muzammil S, New PW, Ahmad N, Haig AJ.
Spinal Rehabilitation Unit, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan. farooqrathore@gmail.com
Recent natural disasters have highlighted the lack of planning for rehabilitation and disability management in emergencies. A review of our experience with spinal cord injury (SCI) after the Pakistan earthquake of 2005, plus a review of other literature about SCI after natural disasters, shows that large numbers of people will incur SCIs in such disasters. The epidemiology of SCI after earthquakes has not been well studied and may vary with location, severity of the disaster,available resources, the expertise of the health care providers, and cultural issues. A lack of preparedness means that evacuation protocols, clinician training, dedicated acute management and rehabilitation facilities, specialist equipment, and supplies are not in place. The dearth of rehabilitation medicine specialists in developing regions further complicates the issue, as does the lack
of national spinal cord registries. In our 3 makeshift SCI units, however, which are staffed by specialists and residents in rehabilitation medicine, there were no deaths, few complications, and a successful discharge for most patients. Technical concerns include air evacuation, early spinal fixation, aggressive management to optimize bowel and bladder care, and provision of appropriate skin care. Discharge planning requires substantial external support because SCI victims must often return to devastated communities and face changed vocational and social possibilities. Successful rehabilitation of victims of the Pakistan earthquake has important implications. The experience suggests that dedicated SCI centers are essential after a natural disaster. Furthermore, government and aid agency disaster planners are advised to consult with rehabilitation specialists experienced in SCI medicine in planning for the inevitable large number of people
who will have disabilities after a natural disaster.
PMID: 18295642 [PubMed - indexed for MEDLINE] 认领！ 近期的自然灾害中，紧急状态下康复和伤残管理缺乏的问题逐渐突出。我们回顾了2005年巴基斯坦地震灾后脊髓损伤（SCI）病例，结合其它关于灾后SCI的文献，显示在此类灾害中会有大量SCI的伤员。目前尚无完善的关于地震后SCI的流行病学调查。SCI可能因地域、灾害严重程度、有效资源、专科诊治水平等因素有关。缺乏准备包括对于紧急撤离、临床医师训练、专科紧急救助、康复设施、专科器材及供应的不完善。在发展中国家，康复科医师的缺乏使这个问题更加严重。然而在我们3家由专科医师和住院医师组成的SCI病房中，没有伤员死亡，几乎未发生并发症，给大部分伤员解除了痛苦。技术方面包括空运后送，早期脊柱固定，积极处理肠道和膀胱损伤，和恰当的皮肤护理。计划要求有强大的外部支持，因为SCI的伤员返回社会后要面对改变工作以及其它一些社会问题。巴基斯坦伤员震后成功的康复有重要的意义，说明专门的SCI中心在自然灾害后是十分必要的。另外，我们建议政府和救助机构应广泛征求在SCI诊治方面有丰富经验的专科医师来应对在后大量出现的此类伤员。
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作者:admin@医学,生命科学 2010-11-18 17:11
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