西安市2025例颅脑损伤住院患者临床及流行病学特点

目的调查分析西安市颅脑损伤(TBI)的临床及流行病学特点,为TBI的预防及治疗提供科学依据。方法采用回顾性队列研究方法。收集西安市6所三甲医院(西京医院、唐都医院、西安交大第一附属医院、西安交大第二附属医院、陕西省人民医院、长安医院)2014年1月1日0时~2014年12月31日24时收治的TBI患者2 025例,应用SPSS 17.0统计软件分析患者的一般资料等情况,同时对TBI发生时间规律、颅内受伤及合并伤、并发症情况以及TBI患者预后相关危险因素分析。结果 2 025例TBI住院患者中,男性1 495例(73.83%),女性530例(26.17%);年龄0.5~99岁,平均41.03岁。各个年龄段的TBI男性明显高于女性,差异有统计学意义(χ~2=12.09,P0.01)。农民是本次调查的最高发人群,中学及以下学历者占近84%。交通伤所占比例最高(39.90%),其次为跌倒伤、坠落伤和击打伤等;多数TBI为闭合性损伤,有1 590例(78.52%);单纯性TBI为762例(37.63%),其余62.37%均伴有不同程度的合并伤,其中以合并皮肤骨骼伤最多见。轻度TBI患者所占比例最大1 485例(73.33%),严重TBI(包括重型及特重型)的比例(15.21%)高于中型TBI(11.46%)。TBI发生时间段方面,1、6、7、8月份发生率较高,一天24h内,12∶00为意外发生的高峰。Logistic回归分析显示脊髓损伤、合并伤、GCS评分、并发症及住院天数等均是影响患者预后的重要因素。结论应加大TBI高峰时间段的交通管制及医疗资源的分配,关注老年人TBI的预防;医务人员在救治TBI患者的同时,应重视对其他系统损伤的处理,尤其是呼吸系统损伤;加强基层医疗单位与综合医院之间的联系,发展康复理疗专业,提高TBI处理能力。

Clinical and epidemiological characteristics of 2025 hospitalized patients with traumatic brain injury in Xi`an city

Objective To investigate the clinical and epidemiological characteristics of traumatic brain injury (TBI) hospitalized patients in Xi`an and provide scientific basis for its prevention and intervention measures.Methods Clinical data of TBI hospitalized patients during Jan.2014 and Dec.2014 from six grade-Ⅲ hospitals in Xi`an were collected and analyzed with retrospective cohort method,including patients` basic information,injury causes,associated injuries,complications,risk factors for treatment methods and prognosis and all data were analyzed using SPSS 17.0 software.Results The male/female ratio in 2025 TBI patients was 2.82∶1 (1495∶530).The mean age of patients was 41.03 (0.5-99) years.Male patients outnumbered female patients in all age groups(x2=12.09,P<0.01).Farmer had the highest proportion of TBI.Traffic injury accounted for the largest proportion (39.90%) of all TBI patients,followed by falls,high falling and bruises.Simple injury accounted for 37.63% (n=762) and the rest were associated with other injuries,mostly skin injuries.Most traumatic brain injury occurred in January,June,July and August,at commuter time and 21 o`clock within one day,and on Saturday and Sunday within a week.Logistic regression analysis showed that spinal cord injury,combined injury,GCS score,complication and hospital days were closely related to TBI prognosis.Conclusion It is necessary to strengthen the traffic management,and the allocation of medical resources at the peak period and to focus on the prevention of elderly TBI.It is suggested to strengthen the connection between primary medical units and general hospitals,and to develop the rehabilitation and physical therapy.