华东地区颅脑创伤流行病学调查

A prospective epidemiological investigation of the hospitalized patients with traumatic brain injury in the Eastern of China

目的了解华东六省一市颅脑创伤住院病人诊治现状流行病学特征，为预防和早期救治颅脑创伤提供理论依据。方法对华东六省一市80家协作医院2004年全年收治的颅脑创伤住院患者进行多中心、前瞻性调查研究，由经治医生严格填写“颅脑创伤流行病学调查表”，采用整群抽样调查方法抽取所有颅脑创伤住院患者数据，并进行SPSS13．0统计分析。结果本次调查研究共收回有效调查表15611份，男：女为3．24：1，平均年龄（39．61±17．90）岁，高发年龄在17～60岁；农民（42．02％）、工人（29．47％）和学生及儿童（9．57％）是前三位发病人群，且文化程度以中学（51．74％）和小学（31．42％）为主。公路（62．34％）、家中（12．80％）、公共场所（10．86％）是颅脑损伤主要发生地点，交通伤（60．42％）、高处坠落伤（13．11％）、击打伤（11．72％）和平地跌倒（10．03％）是主要致病原因。合并伤以颌面部最多（36．26％），其次为四肢（14．94％）和体表（10．62％）及胸部合并伤（9．13％）。首次发现重型颅脑创伤（20．14％）住院比例已经超过中型损伤（18．09％）。颅脑创伤住院患者病死率为6．50％，交通伤患者预后程度较其他组差（χ^2=290．59，P〈0．001）。患者出院后仅1．27％的患者进行康复治疗。结论华东六省一市颅脑创伤主要致病原因为交通伤害，发病群体以青壮年男性为主。必须加强颅脑创伤的预防、干预和救治工作，对高危人群进行预防教育，尤其重视交通事故的预防和控制工作。

Objective To understand the epidemiological characteristics of the hospitalized Patients with Traumatic Brain Injury in the Eastern of China and to supply a base of preservation and remedy for the TBI patients. Methods We gave an muhicentre and prospective study of the TBI patients from 80 hospitals in the Eastern of China in 2004. The tables were finished by the attending physician. We cluster sampling of all the TBI patients, and analysis the data with SPSS 13.0. Result We collected 15 611 utility tables in one year, the male to female ratio was 3.24：1 ,the average age was 39.61 ± 17.90 years old, the major TBI victim was 17-60 years old. Farmers （42.02%） , workers （29.47%） , students and children （9.57%） had the top 3 morbilities. Their education levels are from elementary school （ 31.42% ） to middle school （51.74%）. TBI were mostly happened at highway（62.34% ）, at home（ 12.80% ） and at public place （ 10.86% ）. The major pathogenies were traffic accidents（60.42% ） ,falling from high （ 13.11% ） ,violence （ 11.72% ） and falling down （ 10.03% ）. It could also had the rate of 36.26% to get Maxillofacial region injuries, 14.94% to get limbs injuries, 10.62% to get body surface injuries and 9. 13% to get chest injuries happen together. It was found that the number of severe TBI （ 20. 14% ） are more than medium degree TBI（ 18.09% ）. The fatality ratio of TBI is 6.50%. The prognosis of traffic accident group were worse than other groups（χ^2 = 290.59, P 〈 0. 001 ）. Only 1.27% of the TBI patients went to rehabilitate. Conclusion The major pathogeny in the eastern of China is traffic accident, among these patients, young males are the biggest part . We should enhance the prevention, intervention and remedy work , and educate the high-risk group, especially the prevention and control of the traffic accidents.