脊髓损伤住院患者1027例流行病学分析

摘要

Objective To analyze the epidemiological characteristics of spinal cord injury patients in our hospital.Methods Al the 1 027 spinal cord injury cases from September 2009 to November 2014 were colected from hospital clinical data,and divided into 8 groups according to the causes. Traffic accident(321 cases),faling from height(288 cases),weight-drop impact impact (144 cases),fal and hurt(131 cases),disease(109 cases),vascular malformation(12 cases),sharp instrument/firearm injury (11 cases) and others(11 cases). The whole information of the patients were retrospectively analyzed including gender,age,injury classification,damaged segment,complications and comorbidities.Results The age range for patients with spinal cord injury was (42.5±12.4)years(ranged 4 -83 years);generaly,the male to female ratio was 3.6∶1. Traffic accident was the major cause(321 case,31.26%),and the lowest incidence was sharp/firearm injury(11 case,1.07%). There were 818 cases(79.65%) diagnosed according to the ASIA(American Spinal Injury Association,ASIA) classification. The first 3 mental problems in order were A grade(355 case,34.57%),C grade(182 case,17.72%) and D grade(166 case,16.16%). Average height in high faling injury group was (5.04±3.05)m,and the faling height and injury segment has certain correlation(P<0.05). The top three causes of the complications were bedsore(88 case,8.57%),pneumonia(73 case,7.11%),and urinary tract infection(61 case,5.94%). In addition,the first comorbidity of spinal cord injury was hypertension(69 case,6.72%).Conclusion The treatment platform for spinal cord injury should be established and perfected for preventing and treating spinal cord injury comprehensively.%目的：分析本院脊髓损伤住院患者流行病学特点。方法收集2009年9月—2014年11月本院收治的1027例脊髓损伤患者临床资料，根据致伤原因分为8组。交通事故（321例）、高处坠落（288例）、重物撞击（144例）、摔伤（131例）、疾病（109例）、血管畸形（12例）、锐器/火器伤（11例）及其他（11例），并对性别、年龄、损伤程度、损伤节段、并发症及合并症等进行回顾性分析。结果脊髓损伤患者年龄4~83（42.5±12.4）岁；总体上男女比例为3.6∶1。交通事故伤是主要致伤原因（321例，31.26%），锐器/火器伤比例最低（11例，1.07%）。按照美国脊髓损伤协会（ASIA）标准诊断的患者共818例（79.65%），ASIA分级占前3位的依次为A级（355例，34.57%）、C级（182例，17.72%）、D级（166例，16.16%）。在高处坠落伤组中，坠落高度为（5.04±3.05）m，且坠落高度与损伤节段具有相关性（P<0.05）。脊髓损伤并发症占前3位的依次是褥疮（88例，8.57%）、肺炎（73例，7.11%）和泌尿系感染（61例，5.94%），高血压（69例，6.72%）是脊髓损伤患者的首要合并症。结论应建立并完善脊髓损伤救治平台，全方位防治脊髓损伤。