【摘要】 目的:筛查2008年汶川地震后9个月什邡市6个重灾镇的周围神经损伤患者,并调查这些患者接受康复指导与治疗的情况。方法:调查的什邡市六个重灾镇包括蓥华、红白、师古、八角、湔底和洛水。采用三级筛查方法:第一级,村医将所有在地震中受伤患者的名字列表;第二级,镇医对所有受伤的患者进行体格检查,挑选出可疑周围神经损伤的患者;第三级,来自北京大学第一医院的专家对经过两次筛查的患者进行再次体格检查,初步确定周围神经损伤的人群并定位损伤的神经。在进行第三级筛查的同时,对筛查的对象进行康复医疗状况的问卷调查。最后,对三级筛查出的可疑周围神经损伤的患者进行肌电图检查,确定肌电图表现出周围神经损伤的患者。结果:共有372例进入了第三级筛查。经过三级筛查后,140例存在疑似周围神经损伤,其中,31例(22%)存在疑似运动神经损伤,26例(19%)存在疑似感觉神经损伤,83例(59%)存在疑似混合神经损伤。对于所有疑似周围神经损伤的患者,仅42例(30%)接受过康复指导或治疗。105例进行了肌电图检查,48例存在周围神经损伤的异常肌电图表现。另外,进入第三级筛查的患者中123例存在疼痛,16例日常生活活动能力Barthel指数评测低于正常。结论:地震后9个月仍有许多存在周围神经损伤或疼痛或日常生活活动能力受限的患者,但是大多数人没有接受过康复指导或治疗。在重大灾难的救援中,需要关注潜在的周围神经损伤问题,并且及时给予康复治疗。更多还原

【Abstract】 Objective:To screen the peripheral nerve injured in 6 disaster towns of Shifang City 9 months after Wenichuan earthquake in 2008 and carry out an investigation of rehabilitation instruction and rehabilitation for these injured.Method:There were 6 towns in Shifang City that were disaster regions,including Yinghua,Hongbai,Shigu,Bajiao,Jiandi and Luoshui.Three-grade screening method was used to detect the peripheral nerve injured.Firstly,the village doctors were asked to make sure which person had injury during the earthquake and listed their names.Secondly,the town doctors did the physical examination for the injured and diffentiated which ones were suspected of suffering peripheral nerve injury.Thirdly,the specialists from Peking University First Hospital did physical examination again to make sure if the person had peripheral nerve injury and located the injured nerve.Accompany with the third grade screening,a rehabilitation questionnaire was used to comprehend the rehabilitation circumstance of these injured after earthquake.After the three-grade screening,EMG examinations were tested for the suspected peripheral nerve injured to confirm the injuries manifested in EMG.Result:A total of 372 persons entered the third-grade screening and 140 of them were suspected suffering from peripheral nerve injury 9 months after earthquake.Among them,31(22%) cases were suspected suffering from motor nerve injury,26(19%) sensory nerve injury and 83 (59%) mixed nerve injury.Finally,105 persons had EMG examinations,48 cases of them had peripheral nerve injury abnormal manifests.For all the peripheral nerve injured,only 42 (30%) of them received rehabilitation instruction or treatment.In addition,123/372 persons had pain and 16/372 persons’ Barthel indexes were less than normal.Conclusion:Nine months after earthquake,there were still many people had peripheral nerve injury or pain or the in basic activities of daily living were affected,but most of them hadn’t rehabilitation instruction or treatment.It warns us that after serious disaster among the emergencies,there may be underlying peripheral nerve injury,so we should pay attention to this and carry out rehabilitation when needed.更多还原