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1005例胸腰椎骨折住院患者流行病学特征分析

     

摘要

目的:调查甘肃省中医院1005例胸腰椎骨折病例的流行病学特征。方法:由4人组成调查组入医院病案室调集2011年1月1日至2012年12月31日全部胸腰椎骨折病例,设计调查表对相关因素进行登记,对胸腰椎骨折的流行特征和2年发生情况进行动态分析。结果:共收治胸腰椎骨折1005例,其中男499例,女506例,年龄12~90岁,平均年龄51.8岁;从性别分布看,青壮年时期男性多于女性,中老年时期女性多于男性,胸腰椎骨折的高发人群在46~60岁;仅限于胸腰段椎体骨折(T11~L2)的病例737例,占全部胸腰椎骨折的73.3%;单节段单纯胸腰椎骨折680例,多节段或复合伤325例,占全部胸腰椎骨折的32.3%,合并脊髓或神经损伤146例,占全部胸腰椎骨折的14.5%;骨折的原因以车祸和坠落伤为主,成人体力劳动者为发生率较高的人群。陈旧性骨折108例,新发骨折897例,其中压缩性骨折745例,爆裂骨折120例,骨折脱位12例,屈曲伸展型骨折2例,Chance骨折1例,脊椎附件骨折17例;保守治疗470例,后路手术343例,前路手术5例,球囊椎体成形术76例,内窥镜下手术3例。结论:胸腰椎骨折病例近2年呈上升趋势,且复合伤居多,防治的重点人群为青壮年男性体力劳动者和中老年女性。%Objective: To explore epidemiological features of 1 005 patients inGansuProvincial Hospital of Traditional Chinese Medicine. Methods: All the cases from January, 1st, 2011 to December, 31st, 2012 were collect-ed by four members of the investigation team, the factors were recorded by the questionnaires, epidemiological fea-tures of thoracolumbar fracture and the conditions in recent two years were analyzed dynamically. Results: All 1 005 cases were admitted, there were 499 male patients and 506 female patients, aged from 12 to 90, average age was 51.8 years old; male was more than female in the young adults, female was more than male in the middle-aged, the main group of thoracolumbar fracture were at the age between 46 and 60 years; there were 737 cases of thoracolum-bar vertebra fracture (T11~L2), and they occupied 73.3%; 680 patients of single-segment thoracolumbar fracture, 325 cases of multisegment or compound wound and they held 32.3%, 146 patients complicated with spinal or nerve in-jury and they occupied 14.5%; the reasons of bone fracture were car accident and falling mainly, adult manual work-ers were with high incidence. There were 108 patients suffering from old fracture, 897 patients with new fracture, a-mong them, there were 745 cases of compression fracture, 120 cases of bursting fractures, 12 cases of fracture and dislocation, two cases of buckling stretch fracture, one case of Chance fracture, 17 cases of spinal accessory fracture; 470 cases adopted conservative therapy, 343 cases with posterior approach, five cases with anterior approach, 76 cases of balloon kyphoplasty, three cases of the surgery under endoscope. Conclusion: The cases of thoracolumbar fracture show a increasing trend in recent two years, and mostly compound wound, the important people of preven-tion are male adult manual workers and middle-aged female.

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