河南省15 345例颅脑创伤住院患者的临床特征分析  

Clinical characteristics of 15345 patients with traumatic brain injury in Henan province

作　　者：周少龙[1] 付旭东[1] 马建[1] 孟恩平[1] 杨卓[1] 张恒威 李凌乐[1] 王荷 王新军[1] Zhou Shaolong;Fu Xudong;Ma Jian;Meng Enping;Yang Zhuo;Zhang Hengwei;Li Lingle;Wang He;Wang Xinjun(Department of Neurosurgery,the Fifth Affiliated Hospital of Zhengzhou University,Henan Engineering Research Center of Prevention and Treatment on Craniocerebral Injury,Zhengzhou 450052,China;Department of Disease Prevention and Control,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院神经外科,河南省颅脑损伤防治工程研究中心,郑州450052 [2]郑州大学第一附属医院疾病预防控制科,郑州450052

出　　处：《中华神经外科杂志》2022年第5期452-455,共4页Chinese Journal of Neurosurgery

基　　金：河南省医疗服务能力提升工程建设项目(豫卫医[2017]66号);河南省医学科技攻关计划项目(2018020251);河南省科技计划项目(182102310158)。

摘　　要：目的分析河南省颅脑创伤(TBI)住院患者的临床特征,为规范TBI的防治措施提供理论依据。方法采用前瞻性、多中心研究的方法,2017年1月1日至2020年12月31日,建立由河南省35家不同等级医院组成的TBI住院患者临床特征研究协作组,设计临床信息调查表,并由经治医生填写,应用Epidata 3.1软件进行数据录入并进行统计学分析,从而明确TBI住院患者的临床特征。结果共纳入TBI住院患者15345例,男∶女为3.65∶1.00;年龄为(36.5±16.3)岁(1.5~89.0岁),16~55岁者占比最高(77.1%,11831/15345);重度TBI患者中,服用抗凝药物和(或)抗血小板聚集药物者的病死率(20.5%,69/336)高于未服用上述药物的患者(10.4%,581/5571)(χ^(2)=11.91,P=0.001);致伤原因中,交通事故占比最高(63.4%,9731/15345),其中骑乘电动自行车(25.5%,2481/9731)逐渐成为交通事故致伤主要原因之一。行手术治疗的患者占比为37.7%(5785/15345),其中去骨瓣减压术是最主要的手术方式,占37.2%(2152/5785)。行去骨瓣减压术的患者中,脑积水的发生率为46.0%(990/2152)。行保守治疗者占62.3%(9560/15345)。出院时格拉斯哥预后评级Ⅴ、Ⅳ、Ⅲ、Ⅱ、Ⅰ级者分别为12445例(81.1%)、1347例(8.8%)、476例(3.1%)、322例(2.1%)以及755例(4.9%)。结论河南省颅脑创伤患者以男性为主,主要致伤原因为交通事故,尤其是骑乘电动自行车。经过手术和保守治疗后,总体TBI患者的预后较好,但仍需进一步提高对TBI的救治水平,以降低病死率,改善患者的预后。Objective To explore the clinical characteristics of hospitalized patients with traumatic brain injury(TBI)in Henan province and to provide a theoretical basis for the prevention and standardization of TBI.Methods We established a cooperative group consisting of 35 hospitals of different grades in Henan province and designed a questionnaire from January 1,2017 to December 31,2020.The questionnaires were filled by competent doctors strictly and accurately.Epidata 3.1 was used for data input and statistical analysis to identify the clinical characteristics of TBI inpatients.Results A total of 15345 hospitalized patients with TBI were enrolled into this study and the ratio of male to female was 3.65∶1.00.The patient′s average age was 36.5±16.3 years old(range:1.5-89.0 years old),and the highest incidence of TBI was in the 16-55 years old group(77.1%,11831/15345).Among patients with severe TBI,the mortality of patients taking anticoagulant and/or antiplatelet drugs(20.5%,69/336)was higher than that of patients not taking those drugs(10.4%,581/5571)(χ^(2)=11.91,P=0.001).Among the causes of injury,traffic accidents accounted for the highest proportion(63.4%,9731/15345),of which riding electric bicycles(25.5%,2481/9731)gradually became the main cause of traffic accidents.The proportion of patients undergoing surgical treatment was 37.7%(5785/15345),of which decompressive craniectomy was the main surgical method,accounting for 37.2%(2152/5785).Among patients undergoing decompressive craniectomy,the incidence of hydrocephalus was 46.0%(990/2152).Conservative treatment accounted for 62.3%(9560/15345).Glasgow outcome gradesⅤ,Ⅳ,Ⅲ,ⅡandⅠat discharge were reported in 12445 cases(81.1%),1347 cases(8.8%),476 cases(3.1%),322 cases(2.1%)and 755 cases respectively(4.9%).Conclusions The patients with TBI in Henan Province are mainly male,and the main cause of injury is traffic accidents,particularly riding electric bicycles.After surgery and conservative treatment,the overall outcome of TBI patients is good,but the le

关 键 词：颅脑损伤 前瞻性研究 调查和问卷 临床特征 河南省 

分 类 号：R651.15[医药卫生—外科学]