2005—2007年上海市浦东新区脊柱脊髓损伤调查分析

目的为了解上海市浦东新区脊柱脊髓损伤的发生情况、救治流程以及专科处理情况。方法采取查阅住院病历的形式,对浦东新区所有二级以上医院2005—2007年收治的脊髓损伤患者进行了回顾性调查分析。结果共查阅记录到浦东新区2005—2007年脊柱脊髓损伤住院病历200例。以浦东新区人口总数约300万计算,浦东新区脊髓损伤的年发病率约25/100万;患者平均年龄恰值中年,对劳动力损害较大;职业分布以建筑工人为主;住院费用最高30万元,总住院费用共计967万元,日均住院费用为2 026元,人均住院费用为4.83万元;脊柱脊髓损伤8 h之内到达医院累计117例,仅有32例获得甲基强的松龙的冲击治疗;手术患者141例,平均手术时间3.2 h,平均出血538（200-3 000）m l,而平均输血731（100-2 600）m l;对于疗效评价,原始病历中记载模糊。结论我国脊髓损伤发病率呈上升趋势,加强正确的120医疗救治中心院前急救和临床医生准确规范的程序化处理对于脊柱脊髓损伤的救治至关重要;同时临床医生对脊髓损伤诊断的评价和资料记录仍需进一步提高。

Retrospective study of acute spinal cord injury between 2005 and 2007 in Pudong New Area, Shanghai

Objective To understand the incidence, medical process and specialized management of acute spinal cord injury （ASCI） in Pudong New Area, Shanghai. Methods All the medical records of ASCI between 2005 and 2007 in the first-class and second-class hospitals in Pudong New Area were retrospectively studied. Results A total of 200 cases were included in the study. The annual incidence of ASCI in Pudong New Area was 25 per million; and the majority of patients were middle-aged construction workers, hence it affected the labor force. The highest hospital expense was 300 thousand RMB, and the total expense added up to 9.67 million RMB. The average daily cost was 2,026 RMB, and the per capita cost was 48,300 RMB. Among the 117 cases who reached hospitals in 8 hours after ASCI occurred, only 32 of them were treated with Methylprednisolone at once. Totally, 114 cases underwent surgeries, in which the mean operation time was 3.2 hours, the intraoperative blood loss averaged 538 ml （200 -3 000 ml） and the mean blood transfusion was 731 ml （100 -2 600 ml）. However, the assessment ot ettlcacy in me ongmaf meulcal ~ct：u~u~ wa~ ,~,~ clear. Conclusion The incidence of ASCI has a tendency to increase, and it is of great importance for the treatment of ASCI patients to enhance the correct pre-hospital care at the medical emergency centers and to improve the management process of hospital emergency staff. In addition, the diagnosis, assessment and information recording of ASCI patients remain to be further upgraded.