道路性颅脑损伤院前急救及预后影响因素分析  

Determinants of prognosis and pre-hospital care for road traffic brain injury in Shandong province

作　　者：滕岳[1] 辛涛[2] 滕良珠[2] 徐凌忠[1] 

机构地区：[1]山东大学公共卫生学院社会医学与卫生事业管理研究所,山东济南250012 [2]山东省立医院神经外科

出　　处：《中国公共卫生》2010年第7期839-840,共2页Chinese Journal of Public Health

基　　金：国家自然科学基金(30371454)

摘　　要：目的了解山东省道路性颅脑损伤伤者院前急救情况及其预后影响因素。方法从山东省2004年颅脑创伤住院患者数据库中整群抽取道路性颅脑损伤伤者,除一般资料外,对预后疗效评估的院前影响因素进行单因素和多因素Logistic回归分析。结果 2866例患者平均年龄37.8岁,男女比例约为3:l;2h内得到专业现场救治的占47.6%,现场保持呼吸道通畅的占28.5%、肢体固定占6.5%、颈椎固定占3.4%、院前采取气管插管比例占7.3%;出院时死亡比例占5.5%,半数以上死亡在2h内发生;预后的主要影响有性别、年龄、是否使用摩托车、现场是否呼吸通畅、现场是否肢体固定、院前是否气管插管等。结论改善道路交通环境、提高120反应速度及救护水平等可有效提高交通性颅脑损伤伤者预后康复水平。Objective To investigate the determinants of prognosis and pre-hospital care for road traffic brain injury in Shandong province.Methods Totally 2 866 inpatients with road traffic brain injury in 2004 were selected with cluster sampling from 20 hospitals for a questionnaire survey.The data collected were analyzed with descriptive analysis,univariate and multivariate logistic regression.Results The mean age of the inpatients was 37.8 years and the male to female ratio was about 3：1.47.6% of the patients got professional treatment within 2 hours.The treatments included keeping the airway aptency（28.5%）,physically fix（6.5%）,cervical fixation（3.4%）,tracheal intubation（7.3%）.5.5% of the patients died in hospital and more than half of deaths occurred within 2 hours after the injury.The main factors affecting the prognosis were gender,age,motorcycle ride,respiratory tract unobstructed,body fixed,trachea intubation.Conclusion The prognosis of traffic brain injury could be effectively improved by taking interventions as enhancing road safety education,improving the road traffic environment,speeding the response of first aid,improving ambulance facilities,upgrading professional standards of ambulanceman.

关 键 词：道路性颅脑损伤 预后 院前急救 影响因素 

分 类 号：R532.21[医药卫生—内科学]