8003例住院创伤患者流行病学分析

Epidemiological analysis of the causes of injury in 8003 hospitalized trauma patients

目的分析住院创伤患者致伤原因分布规律,为提高重庆地区创伤的防治水平提供客观、科学的依据。方法采用陆军军医大学野战外科研究所研制的“创伤数据库系统3.0”录入重庆市急救医疗中心的创伤病例资料,建立重庆市急救医疗中心创伤数据库。从此数据库中提取2005年1月—2014年1月住院创伤病例9981例,其中病例信息完整的创伤病例共计8003例,对不同年龄、性别、损伤部位、损伤类型、损伤严重度(AIS和ISS评分)、救治结局的住院创伤患者致伤原因进行回顾性分析。结果本组8003例中男性5581例,女性2422例,年龄4~101岁(平均46.0岁);其中男性(43.3±16.2)岁,女性(52.0±19.6)岁。致伤原因道路交通伤3973例(49.6%),跌倒/坠落伤2414例(30.2%),锐器伤702例(8.8%),钝器伤429例(5.4%),挤压/掩埋伤150例(1.9%),爆炸/火器伤11例(0.1%),其他伤324例(4.0%)。锐器伤患者中,18~44岁构成比最高(75.6%)。18岁及以后,随着年龄增长受伤人数呈下降趋势。跌倒/坠落伤构成比随着年龄增长而递增,在75岁以上患者中达到高峰(56.7%)。女性道路交通伤、跌倒/坠落伤构成比高于男性,男性锐器伤构成比明显高于女性。道路交通伤、跌倒/坠落伤是导致各部位损伤和多发伤的主要原因。挤压/掩埋伤病死率最高(5.3%),跌倒/坠落伤、道路交通伤次之(3.9%、3.5%)。结论重庆地区道路交通伤、跌倒/坠落伤为主要致伤原因,且以多发伤为主,中青年为受伤主体。

Objective To analyze the distribution of injury causes among inpatients with trauma,so as to provide objective and scientific basis for improving the prevention and treatment of trauma in this region.Methods Data of 8,003 trauma patients treated by Chongqing Emergency Medical Center from Jan.2005 to Jan.2014 were enrolled.Epidemiological characteristics of injury causes of inpatients with trauma in different ages,genders,injury sites,damage type,injury severity and treatment outcomes were retrospectively analyzed.Results Among all the 8003 cases,there were 5,581 males and 2,422 females,aged 4-101 years(mean 46.0 years).The average age of male patients was(43.3±16.2)years,and the average age of female patients was(52.0±19.6)years.Causes of injury:3973(49.6%)road traffic injuries,2414(30.2%)fall injuries,702(8.8%)sharp instrument injuries,429(5.4%)blunt force injuries,150(1.9%)crush/burial injuries,11(0.1%)explosion/firearm injuries,and 324(4.0%)other injuries.Among the patients with sharp instrument injury,the composition ratio of 18-44 years old was the highest(75.6%).The number of injuries declined with age 18 and more.The fall injury ratio increased with age and peaked in patients over 75 years of age(56.7%).The composition ratio of road traffic injury,fall injury in female was higher than that of male,and the composition ratio of sharp weapon injury in male was significantly higher than that of female.Road traffic injuries and fall injuries were the main causes of injuries and multiple injuries.Crush/bury injuries had the highest death rate(5.3%),followed by falls and traffic accidents(3.9%and 3.5%).Conclusion Road traffic injuries and falls injuries are the main causes of injuries in this region,which are mostly multiple injuries,and young and middle-aged people are the main group of injuries.