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2008年四川地震后某三级医院颅脑创伤横断面研究:华西医院242例病例简要报告及经验

Cross-sectional study of craniocerebral trauma in a tertiary hospital after 2008 Sichuan earthquake: a brief report of 242 cases and experiences from West China Hospital.

作者信息

Li Qiang, Yang Chao-Hua, Xu Jian-Guo, Chen Jing, You Chao

机构信息

Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.

出版信息

J Trauma. 2011 Jun;70(6):E108-12. doi: 10.1097/TA.0b013e3181fb4976.

Abstract

BACKGROUND

We aim to analyze clinical features of patients with craniocerebral trauma after 2008 Sichuan earthquake in China.

METHODS

Medical records of patients with craniocerebral trauma admitted to Department of Neurosurgery in West China Hospital within 30 days after earthquake were retrospectively analyzed. Demographic data, clinical diagnosis, treatment, and prognosis were reviewed. Patients' data from peripheral hospitals were also analyzed.

RESULTS

Two hundred forty-two patients with craniocerebral injuries were included in the study. The male to female ratio was 1.3:1, and more than half of the patients were between 20 and 60 years. Majority of patients suffered from mild to moderate injuries (88.4%). Scalp wound was the leading type, followed by skull fractures and brain contusion and laceration. Fifty patients (20.7%) underwent craniotomy. Overall mortality was 5.4% (n = 13). In survivors, 186 patients had good outcome (Glasgow Outcome Scale score ≥4, 76.9%). Staphylococcus aureus (n = 74, 44.6%), Aerobacter cloacae (n = 37, 22.3%), and Staphylococcus epidermidis (n = 33, 19.9%) were most frequently isolated bacteria in wound smear. Over 85% (n=6) of patients with infectious wound (n=7) obtained delayed first stage healing. Mortality of patients in local hospitals ranged from 3.8% to 8.9%.

CONCLUSIONS

Most patients admitted to tertiary hospitals are mildly or moderately injured. Cooperation among different departments is critical to shorten delay in emergency room. First stage wound healing or delayed first stage healing can be achieved in most patients after treatment. More than 76% of seismic injury patients in a tertiary medical center have good outcome.

摘要

背景

我们旨在分析2008年中国四川地震后颅脑创伤患者的临床特征。

方法

回顾性分析地震后30天内入住华西医院神经外科的颅脑创伤患者的病历。审查人口统计学数据、临床诊断、治疗及预后情况。还分析了来自周边医院患者的数据。

结果

本研究纳入了242例颅脑损伤患者。男女比例为1.3:1,半数以上患者年龄在20至60岁之间。大多数患者为轻至中度损伤(88.4%)。头皮伤口是主要类型,其次是颅骨骨折和脑挫裂伤。50例患者(20.7%)接受了开颅手术。总死亡率为5.4%(n = 13)。在幸存者中,186例患者预后良好(格拉斯哥预后评分≥4,76.9%)。金黄色葡萄球菌(n = 74,44.6%)、阴沟肠杆菌(n = 37,22.3%)和表皮葡萄球菌(n = 33,19.9%)是伤口涂片最常分离出的细菌。超过85%(n = 6)的感染伤口患者(n = 7)实现了二期延迟愈合。当地医院患者的死亡率在3.8%至8.9%之间。

结论

入住三级医院的大多数患者为轻至中度损伤。不同科室间的合作对于缩短急诊室延误至关重要。大多数患者经治疗后可实现一期愈合或二期延迟愈合。在三级医疗中心,超过76%的地震伤患者预后良好。

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