中国老年颅脑创伤患者基本特征的初步探讨  

Traumatic brain injury in elderly patients in China:a preliminary discussion

作　　者：郎力键 杨春[1,2] 冯军峰 高国一[1,2] 江基尧 Lang Lijian;Yang Chun;Feng Junfeng;Gao Guoyi;Jiang Jiyao(Department of Neurosurgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Shanghai Institute of Head Trauma,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,200127 [2]上海市颅脑创伤研究所,200127

出　　处：《中华神经外科杂志》2021年第5期485-489,共5页Chinese Journal of Neurosurgery

基　　金：上海市人才发展资金(2018077)。

摘　　要：目的初步探讨中国老年颅脑创伤(TBI)患者的基本特征,为临床救治提供参考。方法回顾性分析欧洲颅脑创伤疗效比较研究(CENTER-TBI)中国注册中心于2014年12月至2017年8月收集的全国22个省市56家单位共13627例TBI患者的临床资料。提取其中≥60岁的3694例TBI患者的基线资料、临床表现、治疗措施、转归、损伤原因及损伤地点等信息。采用美国麻醉协会患者体质分级标准(ASA-PS)对患者进行伤前健康状况评估,采用损伤严重程度评分(ISS)、格拉斯哥昏迷评分(GCS)对患者的损伤情况进行评估。结果年龄≥60岁的老年TBI患者占CENTER-TBI中国注册中心全部TBI患者的27.1%(3694/13627);其中60~74岁的患者占74.7%(2760/3694);67.1%(2478/3694)为男性患者。伤前ASA-PS为Ⅰ级和Ⅱ级的患者占89.6%(3309/3694)。ISS的中位数(四分位数)为16(10,24)分;轻型(GCS 13~15分)患者占57.4%(2120/3694)。其中21.1%(779/3694)的患者行手术治疗,11.1%(409/3694)的患者行颅内压监测。92.7%(3426/3694)的患者好转出院,7.3%(268/3694)的患者死亡。损伤原因中,交通伤占46.7%(1726/3694),平地跌落伤占27.2%(1005/3694),二者在不同年龄段的占比差异均有统计学意义(均P<0.001)。损伤地点中,交通道路占53.3%(1970/3694),居家场所占32.4%(1196/3694),二者在不同年龄段的占比差异均有统计学意义(均P<0.001)。结论中国老年TBI患者占比较高,以60~74岁的患者为主,男性患者多见,绝大部分患者的伤前健康状况良好,多数为轻型TBI患者。中国老年TBI患者的损伤原因及场所主要为交通伤和交通道路。Objective To preliminarily discuss the characteristics of elderly patients with traumatic brain injury(TBI)in China and to provide a reference for clinical treatment.Methods The clinical data of a total of 13627 TBI patients collected from 56 hospitals in 22 provinces(cities)in the Chinese registry of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury(CENTER-TBI)from December 2014 to August 2017 were retrospectively analyzed.The baseline data,clinical manifestations,treatment measures,outcome,cause and location of injury of 3694 TBI patients aged 60 years or older were extracted.The American Society of Anesthesiologists Physical Status Classification(ASA-PS)was used to evaluate the pre-injury health status,and the Injury Severity Score(ISS)and Glasgow Coma Score(GCS)were used to evaluate the patient’s injury.Results Elderly TBI patients≥60 years old accounted for 27.1%(3694/13627)of all TBI patients in the CENTER-TBI Chinese Registry.Among them,patients 60 to 74 years old accounted for 74.7%(2760/3694);67.1%(2478/3694)were male patients.Patients with ASA-PS of grade I and II before injury accounted for 89.6%(3309/3694).The median(upper and lower quartiles)of ISS was 16(10,24)points.Patients with GCS 13-15 points accounted for 57.4%(2120/3694).Among them,21.1%(779/3694)of the patients underwent surgical treatment,and 11.1%(409/3694)underwent intracranial pressure monitoring.92.7%(3426/3694)were improved and discharged,and 7.3%(268/3694)of the patients died.Among the causes of injury,traffic injuries accounted for 46.7%(1726/3694),and fall injuries accounted for 27.2%(1005/3694).The differences in the proportions of the two causes in different age groups were statistically significant(both P<0.001).Among the injured locations,traffic roads accounted for 53.3%(1970/3694),and homes accounted for 32.4%(1196/3694).The differences in the proportions of the two locations in different age groups were statistically significant(both P<0.001).Conclusions The proportion of elderly pati

关 键 词：颅脑损伤 老年人 中国 基本特征 

分 类 号：R651.15[医药卫生—外科学]