| Russian second Chechnya war started in August 8, 1999, and the military operations was over basically in April , 2002. During the second Chechnya war, Russian troops were into a total of 150,000 people (including the armed forces increasing by 30,000 for defense). In the course of the war , 42,848 the total number of people were injured and getted sick. Among these, 24852 people were medicine patients, account for 16.6% of armed forces general, and 17996 people were surgery wounded, account for 12.0% of armed forces general. The above data showed that the medicine diseases bring about a large amount of hygiene depletion of members, account for 58% of total depletion of members. The second Chechnya war had the modernized war characteristic, therefore, the study of the characteristic of the internal medicine diseases and rescue organizations of Russian army in this war are of great significance.This study was focus on the type and quantity of internal medicine diseases and the specificity of the medicine rescue organizations in the course of the second Chechnya war. Our research provided the valuable objective reference and theory basis for the develop direction choice of field battle medicine to our military in modern warfare. Our research also provided reference to our military for diagnosis, treatment, prevention and the logistics support of medical care for internal medicine disease patient and the wounded complicated by the internal medicine diseases in modern warfare. At last, our study will provide some useful lessons for the rescue performance of medicine to our army during wartime.Contents and methodsThe characteristic of the internal medicine diseases, the evacuation treatments and the rescue organizations of Russian army in Modern War were studied in the thesis. A retrospective study of statistical analysis was performed from several key points as follows: Firstly, statistic analysis the type and amount of Russian army's internal medicine diseases. Secondly, the feature study of the courses of familiar internal medicine diseases. Thirdly, the characteristic study of occurrence of internal medicine diseases of the wounded with different places and the injury condition. Fourthly, the study of intensive treatment measure to internal medicine disease patient and the wounded.Results1. The type and amount of familiar internal medicine diseases of Russian army in Chechnya WarWe analyzed the internal medicine diseases of various species Russian soldiers who participating in the second Chechnya war. The results showed that the highest incidence of internal medicine diseases were compulsory soldiers, whose incidence of internal medicine diseases is 66.1 percent of the total number of medicine patients, thereinto, the first year of soldiers accounted for 35.6%,the second year of soldiers accounted for 30.5%. Among the three main types of internal medicine diseases which the soldiers often suffered from, the incidence of respiratory diseases was first place, accounted for 66.8% of the total incidence of the internal medicine diseases; the second place was digestive system diseases, accounted for 16.9%;the third place was cardiovascular diseases accounted for 8%;the incidence of other systemic internal medicine diseases all less than 10%.2. Statistic analysis of the clinic course of familiar internal medicine diseases in Chechnya War(1) Diseases of respiratory systemPneumonia and acute bronchitis were the most common respiratory diseases, respectively accounted for 30.5% and 68.2% of the total incidence of the respiratory system diseases, thereinto, the number of the first year and second year soldiers respectively accounted for 23.8 and 49.9% of the total number. The average time to see doctor of the first year of soldiers and the second year of soldiers respectively were 3.4±0.2 and 3.4±0.3 days after the illness, the average time to be admitted to hospitalization for medical treatment were respectively 3.6±0.2 and 4.0±0.3 days after the illness, and about 8.7% of compulsory soldiers were admitted to hospital for medical treatment until the unwell symptoms appeared one week. Winter was the peak incidence of illness: The number of the first and second year of soldiers who suffer from Pneumonia respectively accounted for 81% and 85% of annual number of Pneumonia. The number of the first and second year of soldiers who suffer from acute bronchitis respectively accounted for 88% and 89% of annual number of acute bronchitis.90-94 percent of them take 2-3 medical evacuation phases for treatment. The proportion of pneumonia patients after treatment in three medical evacuation phases of the first and second year of soldiers accounted for 58% and 66%, respectively. The proportion of bronchitis patients after treatment in three medical evacuation phases of the first and second year of soldiers accounted for 39% and 67%, respectively.(2) Diseases of digestive systemIn the digestive system diseases, the incidence of diseases of acute gastroenteritis was highest, accounted for 46.1% of total digestive system diseases. The average time to see doctor of the first year of soldiers and the second year of soldiers respectively was 9.4±4.0 and 15.1±5.9 days after suffering from acute gastroenteritis. It was basically the same that the time to be admitted to hospitalization for medical treatment, but, a small number of sick soldiers hospitalized until sicken for 2~3 months. The incidence of acute gastroenteritis in winter and autumn respectively accounted for 79% and 73.7% of annual number, and these patients often take 2-3 medical evacuation phases for treatment.(3) Circulatory diseasesIn circulatory system diseases, the incidence of neural responsive circulatory dysfunction was highest, accounted for 40.2%。The average time to see doctor of the first year of soldiers and the second year of soldiers respectively were 3.4±0.2 and 3.4±0.3 days after the illness, and the most of the soldiers were in hospital on the same day, but, also some soldiers hospitalized until the unwell symptoms appeared one and a half month. There was no apparent difference of incidence in different seasons in neural responsive circulatory dysfunction. This kind of patients also need 2-3 medical evacuation phases for treatment.3. The common diseases complicated by traumatic medicine of the wounded(1) The characteristics of injuries of the wounded in the second Chechnya War: According to the characteristics of sites of injury, in second Chechnya War, the brain wounded was 28.2%, the neck wounded was 0.8%, the chest wounded was 8.6%, the abdomen wounded was 6.3%, the pelvis wounded was 6.7%, the vertebra wounded was 1.5%, the four limbs wounded was 47.8%. According to the characteristics of conditions of injury, the mile wounded was 40.5%, the middling wounded was33.3%,the serious wounded was24.4%,and the especially serious wounded was 1.8%. According to extent of the injured sites, most of limbs and neck injuries were mile, head injuries were middling wounded, and chest and abdomen or spinal column injuries were serious and especially serious.(2) Surgery injury complicated by internal medicine diseases: respiratory diseases, circulatory diseases, kidney diseases, digestive diseases, blood loss anemia. Complication rate of respiratory diseases accounted for the total number of injured 4.5%.Complication rate of circulatory diseases accounted for the total number of injured 6.5%. Complication rate of kidney diseases accounted for the total number of injured 16.6%. Complication rate of digestive diseases accounted for the total number of injured 8.3%. Complication rate of blood loss anemia accounted for the total number of injured 14.3%.4. Supplementary treatment of the internal medicine disease patients and the complicated by internal medicine disease wounded.(1) In the course of treating to patients of Pneumonia whose weight was abnomal with the standard plan, after increasing supplementary treatment, the symptom disappeared early, the time of hospitlize was shorten greatly.(mile and moderate pneumonia patients who treated with the additional treatments is shortened 7.5 days and 9.3 days respectively. There were no other complicated diseases in the course, and the condition of nutrition was improved.(2) The diseases complicated by medicine relatively occurred lately, after the supplemental treatment methods were added. The rate of complicated diseases reduced greatly and the time of healing up of injury was remarkably shortened.Conclusion:1. The characteristics of internal medicine diseases of Russian army in second Chechnya War(1)The incidence of internal medicine diseases was higher than surgery diseases.(2)The common internal medicine diseases were respiratory system diseases, digestive system diseases and circulatory system diseases.(3)Winter and autumn were the peak incidence of respiratory system diseases and digestive system diseases; there was no difference of incidence of circulatory system diseases in different seasons. (4)The incidence of respiratory system diseases was extremely high because of coldness in Chechnya. (5)Pneumonia and acute bronchitis were the most common respiratory diseases; In the digestive system diseases, the incidence of diseases of acute gastroenteritis was highest; In circulatory system diseases, the incidence of neural responsive circulatory dysfunction was highest. (6)the incidence of diseases in soldiers was higher than in officer, compulsory soldiers; The incidence of diseases in low grade soldiers was higher than high grade soldiers; the diseases of soldiers were mainly functional diseases and the diseases of officer were mainly organic diseases. (7)The incidence of traumatic internal medicine diseases caused by big scale bomb, guerrilla warfare and land mine warfare was also high. (8)The incidence of internal medicine diseases in serious and especially serious wounded was especially high. (9)These patients were often taken 2-3 medical evacuation phases for treatment.2. The shortage of Russian army's rescue organizations of medicine and enlightenment and suggestion to our army.(1)A considerable number of patients whose treating time was no more than 30 days were sent to military hospitals in the rear and garrison hospitals, have no records of whether returning to the forces. (2)The time of hospitalization and in hospital were late. Thus, the targeted treatments were too late. (3)Out-patients were improperly treated sometimes. (4)The extension of laboratory and appliance inspection for patients was not complete. (5)The lack of efficient new drug. (6)Application of physical therapy is not wide enough. (7)There were no unified medical records, so there were difficulties to research them. (8)The number of internal doctors in the front echelon medical institution was not enough during the war.3. Enlightenment and suggestion to our army and the future war(1) The pathogenetic regular pattern of internal medicine diseases in future war:①The rate of depletion of numbers in internal medicine diseases will probably increase.② The tradition diseases may still be that the diseases give first place to respiration, digestion and circulatory system.③The morbidity of internal medicine diseases that caused by biological weapon, gene weapon and other new types of weapons will be increased.④The morbility of Stress-induced psychological diseases that caused by psychological fear to high-tech weapons will be greatly increased.⑤With the extension of the battle space, the outer space diseases, deep-sea diseases and other not common , even the unknown diseases will appear.(2) Prevention and cure of field battle internal medicine diseases need to reinforce:①During pre-war stage, army cadets, hospital medical staff and officers of war should accept training for prevention and cure of some diseases of field battle medicine, especially to young soldiers and officers.②During combat stage, early medical treatment and prevention should be emphasized. Intensification of psychological care will help to overcome the fear of war, facilitate the prevention and treatment of diseases, and enhance immunity. To chronic disease patients should avoid induced factors. We should prevent pollution of water sources in times of war and infectious diseases. The supply of drugs that efficient, fast, easy to carry and use for front-line troops should be ensure.③During off stage, reform of hygiene and disease survey should be strengthen. We should organiz medical establishmen to perform disease survey and physical examination for combatants and report the abnormalities to epidemic prevention departments as soon as possible.(3) Rescue of field battle internal medicine diseases need to reinforce:①Strengthen the power of technology allocation, and improve the skill of rescue. (a). According to different features of war, climate and geography, time of the war, we should estimate the incidence of different internal medicine diseases and determine the quantities of different field physicians in different medical institution. (b). The great psychological threat resulted by big scale kill and wound weapons cause that the incidence of psychological diseases in army in modern war is higher than in the past. Therefore, psychologist should be established. (c). Experts as technical guidance should join in the basic medical establishmen to help doctors of basic medical establishmen to improve their level of expertise and eliminate the disease misdiagnosed.②Enthusiasm of our military medical worker should be improved, and detection and treatment of soldiers′diseases as soon as possible.③ Military medical workers at all levels should eliminate the aspects of non-standard in medical documents and writing of the medical records and strictly abide by the principle of a unified medical records.④We should reduce the steps of rescue, because the more steps of rescue, the more complication. Therefore, we should limit the number of patients which far away from the first echelon hospital, and insure the patients, which can be treated within 15 days, may be treated in the war zone hospital. The patients who treat within 30 days should be treated in the first echelon of medical institutions.⑤We should raise the protective ability of the evacuation of transport, such as armored ambulance, healthy train, hospital ship.⑥Some medical equipment, medicines and equipment that use in the condition of field battle should be supplied.⑦To strengthen epidemic prevention after the war. We should strengthen supervision and inspection of In wartime and postwar, we should strengthen supervision and inspection of the implementation of the health and epidemic prevention that our army′s document rated.
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