颈部创伤急性期致死性伤因meta分析  

Meta-analysis of the cause of Fatal injury in acute phase of neck trauma

作　　者：郑泽源 谢芬 熊星环 许硕贵 郁毅刚[1] ZHENG Zeyuan;XIE Fen;XIONG Xinghuan;XU Shuogui;YU Yigang(Department of Emergency,the Affiliated Dongnan Hospital of Xiamen University(No.909 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army),Fujian Province,Zhangzhou363000,China;Department of Emergency,Changhai Hospital Affiliated to Naval Medical University,Shanghai200000,China)

机构地区：[1]厦门大学附属东南医院(解放军联勤保障部队第九〇九医院)急诊科,福建漳州363000 [2]海军军医大学附属长海医院急诊科,上海200000

出　　处：《中国医药导报》2021年第26期115-120,共6页China Medical Herald

基　　金：军队后勤科研重大项目(BLB18J006)。

摘　　要：目的系统评价颈部创伤急性期(院前及急诊科)致死性伤因。方法系统检索中国知网、万方、PubMed、EMbase等数据库,从建库至2020年9月所有提供急性期内颈部创伤患者死亡数据的文献,应用Stata 15进行数据分析,通过漏斗图评价发表偏倚。结果共纳入文献29篇,颈部创伤患者1276例。meta分析结果显示急性期颈部创伤患者致死性伤因包括颈部脊髓损伤、颈部大血管损伤、颈部呼吸道损伤,死亡率分别为0.06(95%CI:0.04~0.08,P<0.05)、0.06(95%CI:0.03~0.09,P<0.05)、0.03(95%CI:0.01~0.06,P<0.05)。结论急性期内颈部创伤的致死性伤因主要包括颈部脊髓损伤、颈部大血管损伤及颈部呼吸道损伤,积极适当的院前损伤控制性手术干预是进一步改善颈部创伤患者预后的有效方案。Objective To systematic evaluation of the causes of fatal injury in the acute phase(prehospital and department of emergency)of neck trauma.Methods Databases such as CNKI,Wanfang,PubMed and EMbase were searched systematically,and all literatures providing death data of neck trauma patients during the acute period from inception to September 2020 were analyzed using Stata 15,and publication bias was evaluated by funnel plot.Results A total of 29 papers were included,including 1276 patients with neck trauma.Meta-analysis results showed that fatal causes of injury in patients with neck trauma in the acute period included cervical spinal cord injury,cervical macrovascular injury,and the mortality rates were 0.06(95%CI:0.04-0.08,P<0.05),0.06(95%CI:0.03-0.09,P<0.05),0.03(95%CI:0.01-0.06,P<0.05),respectively.Conclusion The fatal injury of neck trauma during the acute period mainly include cervical spinal cord injury,cervical macrovascular injury,and cervical airway injury.Aggressive and appropriate prehospital damage control resuscitation intervention is an effective program to further improve the prognosis of patients with neck trauma.

关 键 词：院前 颈部创伤 死亡 

分 类 号：R653[医药卫生—外科学]