地震后遇难者的尸体处置与传染病预防的系统评价.pdfVIP

汶川地震医疗救援 2008, 8(8): 575 580 中国循证医学杂志 ～ 地震后遇难者的尸体处置与 传染病预防的系统评价 康德英  洪  旗  李幼平  胡  丹  卫茂玲 四川大学华西临床医学院循证医学与临床流行病学教研室（成都 610041 ） 摘要  背景与目的 全球近20 年因地震死亡数十万人，震后大量遇难者尸体是否会造成大面积传染病爆发 一直是全球关注的热点问题。本研究旨在通过全面检索、收集相关文献，系统评价全球近20 年重大地震灾害后有 关遇难者尸体处理及传染病控制的方法及效果，以期为遇难者尸体的科学处置提供当前最佳证据。方法 制定检 索策略，在MEDLINE 、Cochrane 图书馆、CNKI 与WHO 网站上检索并纳入1988 ～2007 年期间地震后尸体处置与 传染病控制的中英文全文文献。采用临床流行病学方法严格评价纳入文献。结果 有关地震后遇难者尸体处理 与传染病爆发的研究文献数量少，且多为描述性研究。本次评价共纳入10 篇文献，包括2 篇述评、4 篇综述和4 个 技术报告。文献分析结果表明，灾后传染病爆发主要与灾民异地安置的卫生条件、人口密度、饮水与食品安全及基 本卫生设施有关，尚无证据表明传染病爆发与尸体有关。现场尸体处置人员应做好自身防护措施。结论 “地震 后遇难者尸体会成为疾病的传染源”是一误区，建议政府部门应将尸体处置原则、模式纳入应急机制与现场救助手 册。同时应强化对媒体、公众的健康教育，消除误区。 关键词 地震；尸体处置；传染病；系统评价 Management of Dead Bodies and Epidemic Control after Earthquake —— An Evidence- Based Approach KANG De-ying, HONG Qi, LI You-ping, HU Dan, WEI Mao-ling Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China Abstract Background and Objective Nearly half of million have been reported dead after earthquakes in recent 20 years, and many people always concern seriously about whether those corpses pose a risk to epidemics after earthquakes. An evidence-based approach was conducted to assess the relationshi p between dead bodies and epidemic disease outbreak systematically. Methods We searched PubMed, The Cochrane Library (Issue 1, 2008), CNKI and WHO website and screened the references of eligible studies. Results A total of 10 papers published beween 1988 to 2007 were included for final analysis, including 2 editorials, 4 reviews and 4 technical reports (technical note or manual). The risk factors for epidemic outbreak after earthquakes were associated primarily with safe water, food and sanitation facilities, as well as the density of population, and no evidence was