深圳市二线关内外颅脑创伤住院病例多因素流行病学分析

发布时间：2018-12-09 17:45

【摘要】：目的：探讨深圳特区二线关内关外颅脑创伤住院患者的流行病学特征；分析关内外住院病例多变量之间的相互关系，评价深圳市关内外颅脑创伤病例的人群特征、发生原因、发生地点、治疗效果和费用的异同，针对性提出预防措施，以降低颅脑损伤住院患者的生命健康和财产的损失。方法：从9167份病例里选择11个急性颅脑创伤病例的变量，包括入院年度、性别、年龄、创伤病情，住院时间、住院费用、创伤发生地点、发生原因、使用交通工具、手术与否和出院时临床效果，首先对总体数据进行描述；然后对关内和关外、性别、年龄段随机分层分组，使用多种检验方法，对比关内外颅脑损伤流行病学特征的异同并进行统计推断；分别探索关内和关外组内变量间的相关和回归关系。结果：(1)关内外患者前三位病因都是车祸、打击伤、坠落伤；发病地点都是普通公路、公共场所、工地；患者使用的工具都是步行、摩托车。(2)关内患者的平均年龄、住院费用、住院时间和手术率分别是29.65±13.77岁、11088.81±25361.69元、20.64±29.30天、67.88％，而关外患者分别是28.55±12.71岁、8474.86±29911.29元、15.92±22.72天、61.25％。(3)Pearson相关分析年龄、住院时间和住院费用得出：年龄与住院总费用的相关系数是0.047，(P=0.000)；住院时间和住院总费用的相关系数是0.382，(P=0.000)。(4)Spearman等级相关分析得出入院年度、是否手术、年龄段和出院疗效呈负相关。(5)病例分层分组检验：关内外男性儿童、女性老年患者在发病原因、关内外男性青年患者颅脑创伤时使用交通工具、中年男性治疗方式三个变量之间有显著性差异(P＜0.05)。结论：(1)深圳市急性颅脑创伤的前三位伤因是车祸、暴力和工伤。(2)关外患者比关内患者发病年龄轻、住院费用低、住院时间短、手术率低，推断关外患者病情轻、非手术治疗比例高。(3)人群分层统计：关内男性儿童坠落伤多而关外儿童跌倒伤多；关内女性老年更多的是跌倒伤害而关外女性老年更多是车祸；关内男青年是步行受伤多而关外男青年摩托车事故多；治疗上关外中年男性患者非手术率高。(4)年龄和住院费用呈轻度正相关，住院时间和住院费用呈显著正相关。入院年度、年龄增加、保守治疗三个变量和出院效果呈负等级相关。住院时间和住院费用之间有明确的回归关系。推断深圳市近年来颅脑损伤患者出院疗效下降与病情加重、年龄增大和保守治疗有关；减少住院时间可以降低医疗费用，(5)深圳市特区二线关内、关外颅脑创伤住院病例多变量之间的异同对于分析全国的城市中心区和郊区、城市和乡村颅脑损伤情况有借鉴意义。
[Abstract]:Objective: to investigate the epidemiological characteristics of inpatients with traumatic brain injury (TBI) in the second pass of Shenzhen Special Zone. This paper analyzes the relationship between multivariate of inpatients in and out of Guan, evaluates the population characteristics, causes, location, therapeutic effect and cost of the patients with craniocerebral trauma in and out of Guan in Shenzhen, and puts forward some preventive measures. In order to reduce brain injury inpatients with health and property loss. Methods: eleven variables of acute craniocerebral trauma were selected from 9167 patients, including year of admission, sex, age, condition of trauma, length of stay, cost of hospitalization, location of trauma, cause of trauma, use of transportation. Whether or not the operation was performed or not and the clinical effect at the time of discharge, the overall data were first described. Then it divided randomly into three groups: inside and outside Guan, gender, age group, using many kinds of test methods, compared the similarities and differences of epidemiological characteristics of brain injury inside and outside Guan, and made statistical inference; To explore the correlation and regression relationship between the variables in Guan-in and outside-Guan groups respectively. Results: (1) the first three etiology of the patients in and out of Guanguan were traffic accident, attack injury, falling injury, the incidence place were all common highway, public place, construction site; The tools used by the patients were walking and motorcycles. (2) the average age, hospitalization cost, hospitalization time and operation rate of the patients were 29.65 卤13.77 years old, 11088.81 卤25361.69 yuan, 20.64 卤29.30 days, 67.88 years old, respectively. The correlation coefficient between age and total cost of hospitalization was 0.047, and the correlation coefficient between age and total cost of hospitalization was 0.047, and the age was 28.55 卤12.71 years old, 8474.86 卤29911.29 yuan, 15.92 卤22.72 days and 61.25 days respectively. (3) Pearson correlation analysis age, length of stay and cost of hospitalization showed that the correlation coefficient between age and total cost of hospitalization was 0.047. (P0. 000); The correlation coefficient between length of stay and total cost of hospitalization was 0.382. (P0. 000). (4) Spearman grade correlation analysis showed that the year of admission, Age was negatively correlated with the efficacy of discharge. (5) case stratification group test: male children inside and outside Guan, female elderly patients in the cause of the disease, young male patients inside and outside Guan used transportation when traumatic brain injury, There was a significant difference among the three variables in the treatment style of middle aged men (P < 0.05). Conclusion: (1) the first three causes of acute craniocerebral trauma in Shenzhen are traffic accident, violence and injury. The proportion of non-operative treatment was high. (3) population stratification statistics: male children fall more injuries and children fall more than others; The older women in Guan are more injured by falling and the older women are more in traffic accidents, the young men in Guan are more injured in walking than in motorcycle accidents in Guanwai. The non-operative rate of middle aged male patients was high. (4) Age had a slight positive correlation with the cost of hospitalization, and there was a significant positive correlation between the length of hospitalization and the cost of hospitalization. Admission year, age increase, conservative treatment of three variables and discharge results were negative grade correlation. There is a clear regression relationship between the length of stay and the cost of hospitalization. It is inferred that the decrease of discharge effect of patients with craniocerebral injury in Shenzhen in recent years is related to the aggravation of illness, the increase of age and conservative treatment. Reducing the length of hospitalization can reduce the medical costs. (5) the differences and similarities between the inpatients with craniocerebral trauma (TBI) in the second pass of Shenzhen Special Economic Zone and outside, for the analysis of the urban center and suburb of the whole country, The situation of craniocerebral injury in urban and rural areas can be used for reference.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R651.15;R181.3

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