肯尼亚农村地区的创伤

Trauma in rural Kenya.

作者信息

Otieno Tobias, Woodfield John C, Bird Peter, Hill Andrew G

机构信息

Department of Surgery, Africa Inland Church Kijabe Hospital, P.O. Box 20, Kijabe 00220, Kenya.

出版信息

Injury. 2004 Dec;35(12):1228-33. doi: 10.1016/j.injury.2004.03.013.

DOI:10.1016/j.injury.2004.03.013

PMID:15561111

Abstract

BACKGROUND

Trauma in Africa is an increasingly significant problem. The aims of this study were to document the epidemiology and clinical management of trauma in a rural Kenyan hospital and from this to highlight important areas for the medical training of doctors managing trauma in similar situations.

METHODS

Prospective audit of 202 consecutive trauma patients admitted to Kijabe Hospital.

RESULTS

The mean patient age was 31, 77% were males. The median Injury Severity Score (ISS) was nine. The median distance to hospital was 60 km, with a 9 h delay in presentation. Injury mechanisms included road traffic accidents 52%, fall 22%, assaults 13% and burns 6%. The main injuries were limb fractures, soft tissue injuries, head injury and haemo/pneumothorax. Common interventions included fracture management, wound debridement, chest drain insertion, blood transfusion and skin grafting. The overall mortality rate was 3.5%.

CONCLUSION

With appropriate resources and training, good trauma outcomes are possible. The importance of access to hospital care and orthopaedic training are highlighted.

摘要

背景

非洲的创伤问题日益严重。本研究的目的是记录肯尼亚一家乡村医院创伤的流行病学情况及临床管理，并据此突出在类似情况下处理创伤的医生医学培训的重要领域。

方法

对连续收治到基贾贝医院的202例创伤患者进行前瞻性审计。

结果

患者平均年龄为31岁，77%为男性。损伤严重程度评分（ISS）中位数为9分。到医院的中位距离为60公里，就诊延迟9小时。损伤机制包括道路交通事故（52%）、跌倒（22%）、袭击（13%）和烧伤（6%）。主要损伤为四肢骨折、软组织损伤、头部损伤和血胸/气胸。常见的干预措施包括骨折处理、伤口清创、胸腔闭式引流、输血和植皮。总死亡率为3.5%。