云南部分地区颅脑创伤流行病学特征分析

发布时间：2018-11-19 15:20

【摘要】：[目的]:收集颅脑创伤患者的资料,对颅脑创伤患者的年龄、性别、职业,创伤原因、类型,合并伤、治疗及预后等特点进行研究分析,提高颅脑创伤救治水平。[方法]:本研究采取回顾性研究的方法,查阅昆明医科大学第一附属医院2004年1月1日～2013年12月31日住院治疗的所有颅脑创伤患者病例资料,包括直接入住本院的和外院转入的,共3552例患者进行分析。收集资料主要包括:性别、年龄、职业,创伤原因,颅脑创伤类型、程度,合并伤、并发症,治疗方法及预后,并进行统计学分析。[结果]:本次研究病例首诊于我院的有2044例,云南省各地州医院转入的患者为1508例。来源于急诊科304例,神经外一科2548例,微创神经外科520例,重症监护室180例,共3552例。男性患者所占比例为75.08%(2667例),女性所占比例为24.91%(885例),男女比例是3.01:1。患者平均年龄41.66±15.72岁,主要是中年人;农民是发生颅脑创伤最多的职业,其次是工人;创伤发生原因排名前三的是车祸伤1608例(45.27%)、高处坠落伤672例(18.92%)与跌倒伤624例(17.57%);创伤类型从多到少依次是脑挫裂伤1688例,蛛网膜下腔出血851例,硬膜下血肿762例;颅脑创伤严重程度分为轻型(GCS13-15分)患者为1112例,中型(GCS9-12分)为1360例,重型(GCS6-8分)为736例,特重型(GCS3-5分)为344例;合并伤发生概率最高的是肋骨骨折332例(9.35);136例(3.83%)患者并发感染,是出现最多的并发症。手术治疗的患者有992例(27.93%),非手术治疗为2560例(72.07%)。出院时死亡(GOS评分I级)172例(4.84%),良好、正常生活2833例(GOS评分V级)。[结论]:云南部分地区颅脑创伤患者,以男性为主;发生年龄以中年为高发人群;从事体力劳动者,如农民、工人,创伤的发生概率最高;创伤发生原因排名前三的是车祸伤、坠落伤与跌倒伤。颅脑创伤类型最多的是脑挫裂伤,其次是蛛网膜下腔出血,三分之二的患者治疗方式为非手术治疗,我院颅脑创伤病死率为4.84%,颅脑创伤严重程度对患者预后影响很大。
[Abstract]:Objective: to collect the data of patients with craniocerebral trauma, and analyze the characteristics of age, sex, occupation, cause, type, combined injury, treatment and prognosis of patients with traumatic brain injury, so as to improve the treatment level of traumatic brain injury. [methods]: a retrospective study was conducted to review the data of all patients with craniocerebral trauma hospitalized in the first affiliated Hospital of Kunming Medical University from January 1, 2004 to December 31, 2013. A total of 3552 patients were analyzed, including those admitted directly to our hospital and transferred to the hospital. The data included sex, age, occupation, cause of trauma, type, degree, complication, treatment and prognosis of craniocerebral trauma. Results: 2044 cases were first diagnosed in our hospital and 1508 cases were transferred from prefectural hospitals in Yunnan province. 2548 cases were from emergency department, 2548 cases from outside department, 520 cases from minimally invasive neurosurgery, and 180 cases (3552 cases) from intensive care unit. The proportion of male patients was 75.08% (2667 cases) and that of women was 24.91% (885 cases). The ratio of male to female was 3.01: 1. The average age of the patients was 41.66 卤15.72 years old, mainly middle-aged, peasants were the occupation with the most traumatic brain injury, and the workers were the next. 1608 cases (45.27%) suffered from traffic accidents, 672 cases (18.92%) from high falls and 624 cases (17.57%) from falls. 1688 cases of cerebral contusion and laceration, 851 cases of subarachnoid hemorrhage and 762 cases of subdural hematoma. The severity of craniocerebral trauma was divided into mild (GCS13-15) 1112 cases, moderate (GCS9-12) 1360 cases, severe (GCS6-8) 736 cases and GCS3-5 (GCS3-5) 344 cases. 332 cases (9.35) of rib fracture and 136 cases (3.83%) of complicated infection were the most common complications. 992 cases (27.93%) were treated surgically and 2560 cases (72.07%) were treated without operation. There were 172 cases (4.84%) died at discharge (GOS grade I) and 2833 cases had normal life (GOS grade V). [conclusion]: in some parts of Yunnan, the patients with traumatic brain injury are mainly male, middle age is the high incidence group, manual workers, such as farmers and workers, have the highest probability of trauma. The top three causes of trauma are traffic accidents, falls and falls. The most common type of craniocerebral trauma was cerebral contusion and laceration followed by subarachnoid hemorrhage. 2/3 of the patients were treated by non-operative treatment. The fatality rate of craniocerebral trauma in our hospital was 4.84. The severity of craniocerebral trauma had a great influence on the prognosis of the patients.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.15

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