15 074例住院创伤患者流行病学特征调查分析

Analysis on the Epidemiological Characteristics of 15 074 Cases of Hospitalized Patients with Trauma

目的调查分析住院创伤患者流行病学特征及变化规律,完善创伤救治规范,提高严重创伤患者的救治成功率。为提高本地区创伤的救治和防范水平提供客观、科学的依据。方法回顾性分析2008—2011年广西医科大学第四附属医院收治的15 074例住院创伤患者的临床资料,对其性别、年龄、受伤时间、致伤部位、致伤原因、创伤严重程度等信息进行统计分析。结果 2008—2011年住院创伤患者年平均增长速度为3.79%。死亡188例,平均病死率为1.25%。男10 883例,女4 191例。年龄0~108岁,平均（38.7±19.3）岁;7~10月份住院创伤患者较多,2月份最少;8：00~9：59、12：00~13：59、18：00~19：59为每日创伤发生的3个高峰时段;常见致伤部位为四肢（7095/15 074,47.07%）、头部（2 872/15 074,19.05%）、颌面颈部（1 657/15 074,10.99%）;首要致伤原因为交通事故伤（4 541/15 074,30.12%）,其次为跌倒伤（3 883/15 074,25.76%）。利用软件随机抽取3 015例患者损伤严重度（ISS）评分平均为（11.5±6.9）分,生存者ISS评分为（11.3±6.8）分,死亡者ISS评分为（21.2±8.7）分,差异有统计学意义（t=18.728,P〈0.05）。2008—2011年收治住院创伤患者性别、病死率比较,差异均无统计学意义（P〉0.05）;年龄、ISS评分及ISS评分≥16分所占比例比较,差异均有统计学意义（P〈0.05）。结论对创伤好发人群和好发时间段采取针对性措施,以减少创伤的发生;头部创伤病死率高,头盔可以有效减少自行车、摩托车驾乘人员的头部创伤发生概率;交通事故伤是主要致伤原因,加强道路交通安全宣传;创伤严重程度日趋加重,重症、危重症伤员比例增多,应用准确、简便、高效的院前及院内创伤评分方法,完善创伤救治规范,提高严重创伤患者的救治成功率。

Objective To investigate and analyze the epidemiological characteristics and change rules of hospitalized patients with trauma,to perfect trauma standardized treatment,and to improve the treatment success rate for patients with severe trauma. To provide the objective and scientific basis for trauma treatment and prevention level in the region. Methods The medical records of 15 074 hospitalized patients with trauma who were admitted to the Fourth Affiliated Hospital of Guangxi Medical University from 2008 to 2011 were analysed retrospectively,the gender,age,injury time,injury sites,injury cause and severity of injury were statistically analysed. Results The average annual growth rate of number of hospitalized patients with trauma was3. 79% from 2008 to 2011. 188 cases died and the average fatality rate was 1. 25%. The age in years ranged from 0 to 108,with the average age of（ 38. 7 ± 19. 3） years old. Higher numbers of hospitalized patients with trauma were observed from July to October,and lowest numbers of cases were observed in February. The trauma usually occurred in three peak periods： 8： 00 to 9：59,12： 00 to 13： 59,and 18： 00 to 19： 59. Limbs（ 7 095 /15 074,47. 07%）,head（ 2 872 /15 074,19. 05%） maxillofacial and neck（ 1 657 /15 074,10. 99%） were the common injured sites. The leading cause of injury was traffic accident（ 4541 /15 074,30. 12%）,and followed by fall（ 3 883 /15 074,25. 76%）. 3 015 patients were selected randomly by software,the average ISS score was（ 11. 5 ± 6. 9）,the ISS score of survivors was（ 11. 3 ± 6. 8）,and the ISS score of the death was（ 21. 2± 8. 7）,there were significant differences in the ISS score between survivors and death（ t = 18. 728,P 〈0. 05）. From 2008 to2011,there was no significant difference in the gender composition and the fatality rate among different years（ P 〉0. 05）. There were significant differences in the average age,the ISS score,and the proportion of patients whose ISS score ≥16 among different years（ P 〈0. 05）. Conclusion Targeted measures for high risk population and high risk time period need to be taken to reduce the incidence of trauma. Head trauma has a high mortality rate,and helmet can reduce the incidence of head trauma effectively for cyclists and motorcyclists. Traffic accidents are the main causes of trauma,it is advisible to strengthen the propaganda of road traffic safety. Traumatic severity is becoming more aggravated,the proportion of severe and critical cases is increasing. Using the accurate,simple,efficient trauma scoring methods in the pre- hospital and hospital stage,and improving the trauma standardized treatment are expected to improve the treatment success rate for patients with severe trauma.