Chalya Phillipo L, Kanumba Emmanuel S, Mabula Joseph B, Giiti Godfrey, Gilyoma Japhet M
Department of Surgery, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
Tanzan J Health Res. 2011 Jan;13(1):74-81. doi: 10.4314/thrb.v13i1.55118.
Head injury is considered as a major health problem that is a frequent cause of death and disability and makes considerable demands on health services. A cross-sectional study was conducted to determine the etiological spectrum, injury characteristics and treatment outcome of head injury patients at Bugando Medical Centre (BMC) in North-western Tanzania. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS programme. A total of 260 head injury patients (mean age=26.84 years) were studied. Males outnumbered females by a ratio of 1.5:1. Road traffic accidents (RTAs) were the most common cause of injury accounting for 49.2% of patients. Scalp injuries, cerebral concussion and skull fractures were the most common type of head injuries. Fifty-six (21.5%) patients had associated injuries of which musculoskeletal region (36.1%) was commonly affected. Most of patients (66.1%) sustained mild head injury. The majority of patients (75.8%) were treated conservatively and only 24.2% of patients needed surgical interventions. Most of patients (85.4%) had good recovery. The mean hospital stay (LOS) was 24.56 days and the mortality rate was 11.2%. Patients who had RTAs, penetrating head injuries, associated long bone fractures and those who were treated surgically were found to have significantly longer LOS (P< 0.001). Mortality was found to be significantly associated with extreme of age, presence of pre-morbid illness and associated injuries, admission Glasgow Coma Score < 9, systolic blood pressure < 90mmHg, injury severity core > or =16, longer duration of loss of consciousness, the need for intensive care unit admission and finding of space occupying lesion on computed tomography scan (P < 0.001). Head injuries resulting from RTAs remain a major public health problem in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTAs is necessary to reduce the incidence of head injuries in this region.
头部损伤被视为一个重大的健康问题，它是导致死亡和残疾的常见原因，对医疗服务提出了相当高的要求。在坦桑尼亚西北部的布甘多医疗中心（BMC）进行了一项横断面研究，以确定头部损伤患者的病因谱、损伤特征和治疗结果。使用预先测试的编码问卷收集数据，并使用SPSS程序进行分析。共研究了260例头部损伤患者（平均年龄=26.84岁）。男性与女性的比例为1.5:1，男性人数多于女性。道路交通事故（RTA）是最常见的损伤原因，占患者的49.2%。头皮损伤、脑震荡和颅骨骨折是最常见的头部损伤类型。56例（21.5%）患者有合并伤，其中肌肉骨骼区域（36.1%）最常受累。大多数患者（66.1%）为轻度头部损伤。大多数患者（75.8%）接受保守治疗，仅24.2%的患者需要手术干预。大多数患者（85.4%）恢复良好。平均住院时间（LOS）为24.56天，死亡率为11.2%。发现发生RTA、穿透性头部损伤、合并长骨骨折的患者以及接受手术治疗的患者住院时间明显更长（P<0.001）。发现死亡率与年龄极端情况、病前疾病的存在和合并伤、入院时格拉斯哥昏迷评分<9、收缩压<90mmHg、损伤严重程度评分>或=16、意识丧失持续时间更长、需要入住重症监护病房以及计算机断层扫描发现占位性病变显著相关（P<0.001）。在坦桑尼亚的这一地区，由RTA导致的头部损伤仍然是一个主要的公共卫生问题。采取针对减少RTA发生的紧急预防措施对于降低该地区头部损伤的发生率是必要的。
