目的了解不同震级的地震对地震医学救援中三甲医院所收治伤员伤情的差异,为地震医学救援决策的制定和医疗资源的配置提供参考。方法回顾性分析2008年“5 12”汶川地震和“4 20”芦山地震中四川大学华西医院收治的住院地震伤员的临床资料,比较两次地震伤员的性别、年龄、来院时间、受伤机制、伤情分类和治疗转归。结果共纳入汶川地震伤员1 856例,其中男974例、女882例,年龄(45.8±22.7)岁;芦山地震伤员316例,其中男174例、女142例,年龄(43.0±23.1)岁。两次地震伤员的性别与年龄差异均无统计学意义(P>0.05)。但汶川地震伤员来院的高峰明显后移,持续时间明显延长;汶川地震中,重物砸伤和掩埋伤所占比例明显高于芦山地震,伤情也明显较重,住院死亡率明显较高;与汶川地震伤员相比,芦山地震伤员中胸外、颅脑外伤的患者比例明显较高,四肢外伤的比例有所下降。结论 (1)地震时地质物理破坏程度将会对地震伤员的受伤机制产生明显影响,高震级的地震,重物砸伤和掩埋伤的患者比例将会明显增高,相应的,高处坠落伤和跌伤的患者比例会下降,导致患者病情更重,死亡率更高。(2)地震时地质物理破坏程度将会明显影响到地震伤员的后送,越高震级的地震后,伤员来院的高峰会越往后推迟,甚至无明显的高峰出现,但病员流的时间会明显延长,对医院工作的影响较持久。相应的,在伤员后送影响不大的较低震级地震中,伤员来院的高峰会明显提前,病员流的持续时间不会太长,对医院日常工作的影响持续较短。(3)伤员后送的障碍将会影响到患者的及时处理,从而影响到胸外、颅脑外伤患者的预后,最后影响到到院伤员胸外和颅脑外伤的构成比例。与震级较高的地震相比,在较低震级的地震后,应更加加强胸外科、神经外科的救治力量,以保证对此类伤员的及时救治。 Objective To understand the differences of the injuries caused by earthquakes of different magnitudes to the wounded in the top three hospitals in earthquake medical rescue, and provide references for the formulation of earthquake medical rescue decisions and the allocation of medical resources. Methods We retrospectively analyzed the clinical data of the wounded in hospital wounded in West China Hospital of Sichuan University in 2008 Wenchuan Earthquake and Mayushan Earthquake in Sichuan Province. We compared the gender, age, hospitalization time, Injury mechanism, injury classification and treatment outcome. Results There were 1 856 cases of wounded people in Wenchuan earthquake, including 974 males and 882 females, with an average age of (45.8 ± 22.7) years; 316 were Lushan earthquake victims, including 174 males and 142 females, with an average age of 43.0 ± 23.1 years. There was no significant difference in gender and age between the two wounded (P> 0.05). However, the peak of the wounded people from Wenchuan Earthquake moved back to the hospital and significantly prolonged the duration of the injury. In the Wenchuan earthquake, the proportion of injured and buried burdens of heavy objects was significantly higher than that of the Lushan earthquake. The injuries were also significantly heavier and the in-hospital mortality was significantly higher. Compared with the wounded in Wenchuan earthquake, the proportion of patients with extra-thoracic and traumatic brain injury in Lushan earthquake was significantly higher, and the proportion of traumatic limbs decreased. Conclusions (1) The degree of geological and physical damage during the earthquake will have a significant impact on the injury mechanism of the earthquake victims. The proportion of high-magnitude earthquakes, heavy hitches and land-burns will be significantly increased. Correspondingly, The proportion of patients who fall or fall will decline, resulting in more serious illness and higher mortality. (2) The degree of geophysical damage during the earthquake will obviously affect the evacuation of the earthquake victims. The higher the magnitude earthquake, the later the summit of the wounded people will be delayed and even the peak will not appear. However, the patient flow time will be Significantly longer, more lasting impact on the work of the hospital. Correspondingly, in the lower magnitude earthquakes with little impact on the evacuation of the wounded, the peak of the wounded people coming to the hospital was obviously advanced, the duration of the patient’s flow would not be too long, and the impact on the daily work of the hospital lasted for a short time. (3) The obstacles of evacuation of the wounded will affect the timely treatment of the patients, thus affecting the prognosis of patients with chest and traumatic brain injury, and finally affecting the composition ratio of extrathoracic and traumatic brain injury to the wounded. Compared with earthquakes of higher magnitude, thoracic surgery and neurosurgery should be further strengthened after earthquakes of lower magnitude to ensure timely treatment of such wounded people.