2018年中国创伤性脊髓损伤流行病学特点  

Epidemiological characteristics of traumatic spinal cord injury in China in 2018

作　　者：郝定均[1] 贺宝荣[1] 闫亮[1] 都金鹏 亓晓 于石成 张娇娇 郑文静 张荣强 黄大耿 杨俊松[1] 朱铭 欧阳佳伟 赵赫 丁柯元 师浩东 曹阳[1] 张鹰 唐清华 刘元 张子龙 王宇航 田野[1] 陈浩[1] 白露露 李恒[1] 穆晨晨 王宥涵 王晓晖 姜超 林建华[4] 林斌 范顺武 聂林[7] 宋洁富[8] 马迅 邵增务[10] 高延征[11] 官众[12] 宋跃明[13] 马维虎[14] 陈其昕[15] Hao Dingjun;He Baorong;Yan Liang;Du Jinpeng;Qi Xiao;Yu Shichen;Zhang Jiaojiao;Zheng Wenjing;Zhang Rongqiang;Huang Dageng;Yang Junsong;Zhu Ming;Ouyang Jiawei;Zhao He;Ding Keyuan;Shi Haodong;Cao Yang;Zhang Ying;Tang Qinghua;Liu Yuan;Zhang Zilong;Wang Yuhang;Tian Ye;Chen Hao;Bai Lulil;Li Heng;Mu Chenchen;Wang Youhan;Wang Xiaohui;Jiang Chao;Lin Jianhua;Lin Bin;Fan Shunwu;Nie Lin;Song Jiefu;Ma Xun;Shao Zengwu;Gao Yanzheng;Guan Zhong;Song Yueming;Ma Weihu;Chen Qixin(Department of Spine Surgery,Honghui Hospital,Xi'an Jiao Tong University,Xi'an,710054,China;Office of Epidemiology,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Office of Epidemiology,School of Public Health,Shaanxi University of Traditional Chinese Medicine,Xianyang 712038、China;Department of Spine Surgery,First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Orthopedics,909th Hospital of PLA Joint Logistics Support Force,Zhangzhou 363000,China;&Department of Orthopedics,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310020,China;Department of Spine Surgery,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Orthopedics,Shanxi Provincial People's Hospital,Taiyuan 030012,China;Department of Orthopedics,Shanxi Bethune Hospital,Taiyuan 030022,China;Department of Orthopedics,Union Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China;Department of Orthopedics,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Spine Surgery,Qinghai University Affiliated Hospital,Xining 810001,China;Department of Spine Surgery,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Spine Surgery,Ningbo No.6 Hospital,Ningbo 315040,China;Department of Orthopedics,Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]西安交通大学附属红会医院脊柱外科,710054 [2]中国疾病控制与预防中心流行病学办公室,北京102206 [3]陕西中医药大学公共卫生学院,咸阳712038 [4]福建医科大学第一附属医院脊柱外科,福州350005 [5]解放军联勤保障部队第九〇九医院骨科,漳州363000 [6]浙江大学附属邵逸夫医院骨科,杭州310020 [7]山东大学附属齐鲁医院骨科,济南250012 [8]山西省人民医院骨科,大原030012 [9]山西白求恩医院骨科,太原030032 [10]华中科技大学同济医学院附属协和医院骨科,武汉430022 [11]河南省人民医院骨科,郑州450003 [12]青海大学附属医院脊柱外科,西宁810001 [13]四川大学华西医院脊柱外科,成都610041 [14]宁波第六医院脊柱外科,315040 [15]浙江大学医学院附属第二医院骨科,杭州310009

出　　处：《中华创伤杂志》2021年第7期618-627,共10页Chinese Journal of Trauma

基　　金：国家自然科学基金(81830077,81772357);陕西省科技厅社发项目(2020SF-187);西安市卫生健康委员会项目(2020yb34)。

摘　　要：目的统计和分析2018年中国创伤性脊髓损伤发病率的流行病学特点。方法采用多阶段分层整群抽样的方法,从我国3个区域、9个省、27个市随机抽取具有收治脊髓损伤患者能力的医院,回顾性调查2018年收治的符合条件的创伤性脊髓损伤患者。计算全国及各区域的发病率。通过病案调查表采集患者的一般资料、致伤原因、损伤水平、损伤程度、合并骨折节段和类型、合并伤、并发症、死亡情况等数据,并根据地理区域、年龄、性别进行分析。结果本研究纳入4 134例患者的医疗记录,其中男女比例为2.99∶1。中国2018 年创伤性脊髓损伤发病率为50. 484人次/100万人(95%CI 50.122~50.846)。东部地区的发病率最高为53. 791人次/100万人(95%CI 53.217~54.365)。主要致伤原因在全国为高处坠落伤(29.58%),西部地区同全国(40.68%),而东部地区和中部地区为交通伤(31.22%、30.10%)。主要损伤水平在全国为颈髓(64.49%),且中部地区颈髓损伤的比例最高(74.68%),西部地区腰骶髓损伤的比例最高(32.30%)。损伤程度发生率最高的为不完全性四肢瘫(55.20%),且在各个地区的分布规律一致。65.87%的患者合并骨折或脱位,其中西部地区合并比例高达77.95%,而中部地区合并比例仅54.77%。在全国,以头颈部为最主要合并伤(37.87%),东部、中部地区的合并伤分布规律同全国,而西部地区以胸部合并伤(38.57%)的比例最高。32.90%的患者并发呼吸系统并发症。23例(0.56%)患者院内死亡,其中17例(73.91%)因呼吸功能障碍死亡。结论我国创伤性脊髓损伤的高发病率地区是东部,主要致伤原因为高处坠落伤,以颈髓损伤为最主要损伤节段,以不完全性四肢瘫发生率最高,以头颈部损伤为最主要合并伤,以呼吸系统并发症为最主要并发症。Objective To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions,9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018.National and regional incidence rates were calculated.The data of cause of injury,injury level,severity of injury,segment and type of fracture,complications,death and other data were collected by medical record questionnaire,and analyzed according to geographical region,age and gender.Results Medical records of 4,134 patients were included in this study,with a male-to-female ratio of 2.99:1.The incidence of traumatic spinal cord injury in China in 2018 was 50.484/1 million(95%CI 50.122-50.846).The highest incidence in the Eastern region was 53.791/1 million(95%CI 53.217-54.365).In the whole country,the main causes of injury were high falls(29.58%),as well as in the Western region(40.68%),while the main causes of injury in the Eastern and Central regions were traffic injuries(31.22%,30.10%).The main injury level was cervical spinal cord in the whole country(64.49%),and the proportion of cervical spinal cord injury in the Central region was the highest(74.68%),and the proportion of lumbosacral spinal cord injury in the Western region was the highest(32.30%).The highest proportion of degree of injury was incomplete quadriplegia(55.20%),and the distribution pattern was the same in each region.A total of 65.87%of the patients were complicated with fracture or dislocation,77.95%in the Western region and only 54.77%in the Central region.In the whole country,the head was the main combined injury(37.87%),as well as in the Eastern and Central regions,while the proportion of chest combined injury in the Western region was the highest(38.57%).A total of 32.90%of the patients were complicated with respiratory complications.T

关 键 词：脊髓损伤 脊柱损伤 流行病学研究 

分 类 号：R651.2[医药卫生—外科学] R181.3[医药卫生—临床医学]