上海市头部外伤患者急诊流行病学特征  

The emergency epidemiologic characteristics of casualties cases with head injury in Shanghai

作　　者：奚才华[1] 姚海军[1] 徐杨[1] 刘永[1] 田恒力[1] 胡锦[1] 周良辅[2] 

机构地区：[1]上海市急性创伤急救中心,上海交通大学附属第六人民医院神经外科,上海200233 [2]复旦大学附属华山医院神经外科

出　　处：《中华急诊医学杂志》2008年第11期1131-1134,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金资助项目（30371454）;联合基金（GM）资助项目（30422201）志谢：感谢华山医院、长海医院、上海市第一人民医院、上海市第六人民医院、上海市第九人民医院、闵行区中心医院、松江区中心医院、普陀区中心医院、金山区中心医院、奉贤区中心医院、吴凇中心医院、市东医院等12家医院对本研究给予支持.

摘　　要：目的了解我国上海市头部外伤急诊患者的就诊时间分布和流行趋势。方法采用前瞻性资料收集的方法，对2004年1月至2004年12月在参加调查的上海市12家医院急诊首诊的头部外伤病例进行调查，并填写统一的调查表，内容包括年龄、受伤时间、致伤原因等。运用SPSS11．5统计学软件包对数据进行描述性分析和t检验。结果本研究共收回调查表19532份，去除重复病例和缺项较多的调查表后，共得到有效调查表18076份（占92．55％）。病例男女性别比为2．11：1。女性患者年龄〉男性（t=10．575，P〈0．01）。20—29岁年龄组为最高发患者群，占24．7％。本市常住病例占所有统计病例的34．2％。12、1、3月份和8月份头部创伤急诊患者明显多于其他月份；而19：00—21：00，16：00—19：00和10：00—12：00为就诊高峰时段。5．1％患者的致伤原因与工作相关。就致伤原因而言，儿童组（〈14岁）和老年组（〉60岁）以坠落伤为首要致伤原因（分别占66．9％和48．4％）；青少年组（15～34岁）以暴力击打伤最为常见（占34．2％）；中青年组（35～59岁）以交通伤占第一位（占37．7％）。受伤情况以头皮损伤（占40．2％）最为多见。85．8％的患者在就诊时接受了CT检查。71．1％的患者在急诊后白行离院，0．5％的患者死亡。结论上海市头部外伤急诊患者在年龄、就诊时间、致伤原因等方面有一定的规律性，掌握头部外伤急诊患者的流行趋势将有助于医院合理安排急诊医疗资源。Objective To analyze the emergency epidemiological characteristics of casualties with head injury in Shanghai. Method By a prospective study,the data of 18 076 casualties with head injury during the whole year 2004 collected from 12 joint hospitals in Shanghai were doctunented well in the unified survey tables with wide-range items filled in by the attending physician, who got the firsthand information from patients and witness. The data were analyzed by using SPPS version 11.5 software. Results Of 18 076 casualties with head injury,the ratio of male to female was 2.11 ： 1. The mean age of female was older than that of male （ t = 10.575, P 〈 0.01）. The highest incidence of casualties occurred in people of twenties （24.7 % ）. The local residents of Shanghai accounted for 34.2 % of casualties. More casualties often occurred in December, January, March and August than in the rest. Of 5.1% casualties with head injury were associated with labour work. The leading cause of injury was different in patient cohorts of different ages. Fall was the most main cause of trauma in children cohort （ aged 〈 14） and the senile patients cohort （aged 〉 60）. The violent assault and traffic accident caused the most head injuries in the adolescent people cohort （aged 15 - 34 years old） and the young people cohort （aged 35 - 59 year old）.The majority of casualties （85.5 % ） received CT scan. The scalp laceration （40.2 % of patients） was seen more often than other types of injury. The mortality of casualties with traumatic brain injury was 0.5 %. Conclusions The kmowledge of epidemiological trend of emergency department visitors with head injury is an important guidance to physicians arranging emergency medical resources rationally and formulating a comprehensive prevention strategy of casualties with head injury.

关 键 词：伤员 头部外伤 急诊 前瞻性 流行病学 

分 类 号：R651[医药卫生—外科学] R181.3[医药卫生—临床医学]