苏州市脊髓损伤患者流行病学分析及相关因素研究

发布时间：2018-10-12 06:49

【摘要】：目的分析脊髓损伤患者的流行病学特点。方法对苏州市2009年~2014年6年的859例脊髓损伤患者进行回顾性流行病学统计分析。结果各个年龄段男性患者始终多于女性患者,脊髓损伤发生最多的年龄段为40~49岁。2009~2014这6年平均年龄整体上有上升趋势,从2009年的平均46.66±15.48岁到2014年的平均49.91±15.85岁。脊髓损伤男性的职业主要是工人(242/589),占比41.1%,女性主要是农民(56/244),占比23.0%。高处坠落是主要的致伤原因,其次是车祸,分别占27.0%和19.4%。其中小于60年龄段主要致病原因是高处坠落和车祸,而大于60年龄段中主要致病原因为椎间盘突出。男性以高处坠落(197/607)32.5%和车祸(124/607)20.4%为主,女性则为脊髓炎(58/252)23.0%和车祸(43/252)17.1%为主。脊髓损伤最易发生的部位为颈段(43.2%)、其次为胸腰段(33.9%),胸段(11.5%)和腰骶段(11.4%)无明显差异。美国脊髓损伤协会(ASIA)分级A级占比19.4%(167/859),B级占比为5.2%(45/859),C级占比为31.5%(271/859),D级占比为39.6%(340/859),E级占比为4.2%(36/859)。脊髓损伤并发症占前三位的分别是泌尿道感染、压疮和肺部感染。结论根据脊髓损伤自身流行病学特点进行相关预防。目的研究脊髓损伤患者并发症的相关影响因素,为脊髓损伤并发症的早期预防提供依据。方法回顾性分析859例脊髓损伤患者的临床资料,对可能影响并发症是否发生的相关因素进行分析,相关因素包括性别、年龄、损伤程度、损伤部位、是否进行过手术和是否使用过糖皮质激素。对这些影响因素进行多因素Logistic回归分析。结果发生并发症共286例,发生率为33.2%(男性247例,女性39例,平均为49.7岁)早期并发症包括泌尿系统感染110例(38.4%),呼吸系统并发症61例(21.3%),电解质紊乱11例(3.8%),压疮48例(16.8%),深静脉血栓22例(7.6%),心血管系统并发症25例(8.7%),消化系统并发症23例(8.0%)。非条件性Logistic回归分析示:年龄损伤程度损伤部位为脊髓损伤患者发生并发症的影响因素。结论脊髓损伤并发症的发生与年龄、损伤程度和损伤部位有密切关系,应早期预防其并发症,改善患者的预后。
[Abstract]:Objective to analyze the epidemiological characteristics of spinal cord injury (sci) patients. Methods 859 patients with spinal cord injury from 2009 to 2014 in Suzhou were analyzed retrospectively. Results the incidence of spinal cord injury in male patients was always higher than that in female patients, and the most common incidence of spinal cord injury was 400-49 years. The average age in 2009 and 2014 showed an overall upward trend, from 46.66 卤15.48 years in 2009 to 49.91 卤15.85 years in 2014. The occupations of men with spinal cord injury were mainly workers (242 / 589), accounting for 41.1%, and women were mainly farmers (56 / 244), accounting for 23.0%. Falling from height was the main cause of injury, followed by traffic accident, accounting for 27.0% and 19.442% respectively. The main causes of disease in the age group less than 60 years were falling from height and accident, but the main cause was herniation of intervertebral disc in the age group of more than 60 years. 32.5% of men fell from a height (1977 / 607) and 20.4% were involved in car accidents (124 / 607), whereas in women they were mainly myelitis (58 / 252) 23.0% and car accidents (43 / 252) 17.1%. Cervical segment (43.2%), thoracolumbar segment (33.9%), thoracic segment (11.5%) and lumbosacral segment (11.4%) were the most likely sites of spinal cord injury. The percentage of (ASIA) grade A (167 / 859), B) was 5.2% (45 / 859), C was 31.5% (271 / 859), D = 39.6%) (340 / 859), E = 4.2% (36 / 859). The first three major complications of spinal cord injury were urinary tract infection, pressure sore and pulmonary infection. Conclusion according to the self-epidemiological characteristics of spinal cord injury, related prevention is carried out. Objective to study the related factors of complications in patients with spinal cord injury (sci), and to provide evidence for early prevention of spinal cord injury (sci). Methods the clinical data of 859 patients with spinal cord injury were analyzed retrospectively. The related factors including sex, age, degree of injury and location of injury were analyzed. Have you ever had surgery and use of glucocorticoids. Multivariate Logistic regression analysis was performed on these influencing factors. Results the incidence of complications was 33.2% (247 males, 39 females). The early complications included urinary system infection in 110 cases (38.4%), respiratory system complication in 61 cases (21.3%), electrolyte disturbance in 11 cases (3.8%), pressure sore in 48 cases (16.8%), deep venous thrombosis in 22 cases (7.6%), cardiovascular system complication in 25 cases (8.7%), digestive system complication in 23 cases (8.0%). Non-conditional Logistic regression analysis showed that the location of age injury was the influencing factor of spinal cord injury. Conclusion the occurrence of spinal cord injury complications is closely related to age, degree and location of injury. It is necessary to prevent the complications and improve the prognosis of the patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.2

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