目的回顾性分析评价2008年5月12日汶川特大地震后3个月内极重灾区危重症医疗救治的绩效,为全球地震医学救援降低死亡率、伤残率,提高康复率提供决策参考。方法查找并分析评价所有与本研究目的相关的回顾性分析、原始研究和二次研究。结果①据不完全统计,震后72小时极重灾区自救伤员共30620人,其中危重伤员数占住院伤病员总人数的22%。②地震极重灾区市属、近灾区市属、省属和部属医疗机构院内危重伤员死亡率依次为12.21%、4.50%、2.50%、2.17%。③二线医院收治住院的躯干、四肢和部位不详骨折、危重伤和其他伤员人数高于一线医院,伤情更重。④震后4个月,转运到三线医院的10373名稳定期伤员出院99.07%,死亡率0.017%。结论①汶川地震极重灾区危重伤员救治基本形成“上级帮下级,重灾区帮极重灾区,一般灾区帮重灾区和极重灾区,极重灾区以自救互救为主”的医疗救治模式。②对极危重伤员采取“四集中”治疗能有效降低死亡率,使重伤员院内死亡比例由15.06%降至2.9%以下。③在准确伤情信息指导下及时、科学、规范的现场分检后送是降低伤残率和死亡率的关键。汶川特大地震极限条件下极重灾区危重症伤员的救治工作还有很大改进空间。 Objective To retrospectively evaluate and evaluate the performance of medical treatment for critically ill patients in severely affected areas within 3 months after the devastating Wenchuan earthquake on May 12, 2008, so as to provide decision-making reference for reducing the mortality rate and disability rate and improving the recovery rate of earthquakes in the world. Methods To identify and analyze all retrospective analyzes, original studies, and secondary studies that are relevant to the purpose of this study. Results ① According to incomplete statistics, a total of 30,620 self-help wounded people were killed in the severely affected areas at 72 hours after the earthquake, of which 22% were seriously wounded and seriously injured. (2) The mortality rate of critical wounded persons in municipal, municipal and subordinate medical institutions in urban and near-disaster-hit areas with extremely severe earthquake areas were 12.21%, 4.50%, 2.50% and 2.17% respectively. Third-tier hospitals admitted to the hospital’s torso, limbs and parts of unknown fractures, critically ill and other casualties higher than the number of hospitals, heavier injuries. ④ 4 months after the earthquake, 10 373 stable patients who were transferred to the third-line hospital were discharged 99.07% of the patients with a mortality rate of 0.017%. Conclusion ① The treatment of critically injured patients in extremely severely affected areas in Wenchuan earthquake basically formed the medical treatment model of “helping the lower-level senior citizens and helping the severely-stricken areas to help the severely-affected areas and helping the severely-hit areas and severely-hit areas in the most-devastated areas and taking the most common areas for self-help and mutual aid in severely-hit areas” . ② The treatment of critically endangered wounded people with “four concentrations” can effectively reduce the mortality rate and reduce the proportion of in-hospital deaths of seriously wounded people from 15.06% to 2.9%. ③ timely, scientific and standardized site inspection under the guidance of accurate injury information is the key to reduce the disability rate and mortality. There is still much room for improvement in the treatment of critically ill wounded people in extremely severely affected areas under the extreme conditions of the Wenchuan Earthquake.