發(fā)布時間：2018-11-19 15:20

【摘要】：[目的]:收集顱腦創(chuàng)傷患者的資料,對顱腦創(chuàng)傷患者的年齡、性別、職業(yè),創(chuàng)傷原因、類型,合并傷、治療及預(yù)后等特點進(jìn)行研究分析,提高顱腦創(chuàng)傷救治水平。[方法]:本研究采取回顧性研究的方法,查閱昆明醫(yī)科大學(xué)第一附屬醫(yī)院2004年1月1日～2013年12月31日住院治療的所有顱腦創(chuàng)傷患者病例資料,包括直接入住本院的和外院轉(zhuǎn)入的,共3552例患者進(jìn)行分析。收集資料主要包括:性別、年齡、職業(yè),創(chuàng)傷原因,顱腦創(chuàng)傷類型、程度,合并傷、并發(fā)癥,治療方法及預(yù)后,并進(jìn)行統(tǒng)計學(xué)分析。[結(jié)果]:本次研究病例首診于我院的有2044例,云南省各地州醫(yī)院轉(zhuǎn)入的患者為1508例。來源于急診科304例,神經(jīng)外一科2548例,微創(chuàng)神經(jīng)外科520例,重癥監(jiān)護(hù)室180例,共3552例。男性患者所占比例為75.08%(2667例),女性所占比例為24.91%(885例),男女比例是3.01:1。患者平均年齡41.66±15.72歲,主要是中年人;農(nóng)民是發(fā)生顱腦創(chuàng)傷最多的職業(yè),其次是工人;創(chuàng)傷發(fā)生原因排名前三的是車禍傷1608例(45.27%)、高處墜落傷672例(18.92%)與跌倒傷624例(17.57%);創(chuàng)傷類型從多到少依次是腦挫裂傷1688例,蛛網(wǎng)膜下腔出血851例,硬膜下血腫762例;顱腦創(chuàng)傷嚴(yán)重程度分為輕型(GCS13-15分)患者為1112例,中型(GCS9-12分)為1360例,重型(GCS6-8分)為736例,特重型(GCS3-5分)為344例;合并傷發(fā)生概率最高的是肋骨骨折332例(9.35);136例(3.83%)患者并發(fā)感染,是出現(xiàn)最多的并發(fā)癥。手術(shù)治療的患者有992例(27.93%),非手術(shù)治療為2560例(72.07%)。出院時死亡(GOS評分I級)172例(4.84%),良好、正常生活2833例(GOS評分V級)。[結(jié)論]:云南部分地區(qū)顱腦創(chuàng)傷患者,以男性為主;發(fā)生年齡以中年為高發(fā)人群;從事體力勞動者,如農(nóng)民、工人,創(chuàng)傷的發(fā)生概率最高;創(chuàng)傷發(fā)生原因排名前三的是車禍傷、墜落傷與跌倒傷。顱腦創(chuàng)傷類型最多的是腦挫裂傷,其次是蛛網(wǎng)膜下腔出血,三分之二的患者治療方式為非手術(shù)治療,我院顱腦創(chuàng)傷病死率為4.84%,顱腦創(chuàng)傷嚴(yán)重程度對患者預(yù)后影響很大。
[Abstract]:Objective: to collect the data of patients with craniocerebral trauma, and analyze the characteristics of age, sex, occupation, cause, type, combined injury, treatment and prognosis of patients with traumatic brain injury, so as to improve the treatment level of traumatic brain injury. [methods]: a retrospective study was conducted to review the data of all patients with craniocerebral trauma hospitalized in the first affiliated Hospital of Kunming Medical University from January 1, 2004 to December 31, 2013. A total of 3552 patients were analyzed, including those admitted directly to our hospital and transferred to the hospital. The data included sex, age, occupation, cause of trauma, type, degree, complication, treatment and prognosis of craniocerebral trauma. Results: 2044 cases were first diagnosed in our hospital and 1508 cases were transferred from prefectural hospitals in Yunnan province. 2548 cases were from emergency department, 2548 cases from outside department, 520 cases from minimally invasive neurosurgery, and 180 cases (3552 cases) from intensive care unit. The proportion of male patients was 75.08% (2667 cases) and that of women was 24.91% (885 cases). The ratio of male to female was 3.01: 1. The average age of the patients was 41.66 鹵15.72 years old, mainly middle-aged, peasants were the occupation with the most traumatic brain injury, and the workers were the next. 1608 cases (45.27%) suffered from traffic accidents, 672 cases (18.92%) from high falls and 624 cases (17.57%) from falls. 1688 cases of cerebral contusion and laceration, 851 cases of subarachnoid hemorrhage and 762 cases of subdural hematoma. The severity of craniocerebral trauma was divided into mild (GCS13-15) 1112 cases, moderate (GCS9-12) 1360 cases, severe (GCS6-8) 736 cases and GCS3-5 (GCS3-5) 344 cases. 332 cases (9.35) of rib fracture and 136 cases (3.83%) of complicated infection were the most common complications. 992 cases (27.93%) were treated surgically and 2560 cases (72.07%) were treated without operation. There were 172 cases (4.84%) died at discharge (GOS grade I) and 2833 cases had normal life (GOS grade V). [conclusion]: in some parts of Yunnan, the patients with traumatic brain injury are mainly male, middle age is the high incidence group, manual workers, such as farmers and workers, have the highest probability of trauma. The top three causes of trauma are traffic accidents, falls and falls. The most common type of craniocerebral trauma was cerebral contusion and laceration followed by subarachnoid hemorrhage. 2/3 of the patients were treated by non-operative treatment. The fatality rate of craniocerebral trauma in our hospital was 4.84. The severity of craniocerebral trauma had a great influence on the prognosis of the patients.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R651.15

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