Chen Yong, Qiu Jun, Yang Ao, Yuan Danfeng, Zhou Jihong
State Key Laboratory of Trauma, Burns and Combined Injury, Department 4, Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China.
Exp Ther Med. 2017 May;13(5):2102-2108. doi: 10.3892/etm.2017.4208. Epub 2017 Mar 9.
In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c=0.034). However, there was a significant difference in the gender distribution of splenic injury patients in different months (P<0.05, c=0.063). In addition, admission numbers for splenic injury were highest in September, October and November. It was also found that splenic injury may occur at all ages, though patients of working age (20-50 years), which comprises 85.59% of patients, the highest proportion of all recorded cases. Associations between mortality rate and each management strategy were as follows: Operative management, 0.11% and non-operative management, 0.15%. Furthermore, multivariate analysis demonstrated that transfusion, New Injury Severity Score and management strategies were all correlated with mortality rate. Thus, despite a lack of data for inpatients from civilian hospitals, the present study has, in part, identified the epidemiology and management strategies of splenic injury in China. These findings may supplement those from previous analyses of splenic injury in other countries and regions.
在中国，关于脾损伤的流行病学及治疗的荟萃分析较少。鉴于中国军队医院在国内脾损伤治疗方面取得的成功，本研究对这类病例进行了系统回顾，确定了脾外伤的高发生率以及中国脾损伤的多种治疗策略。数据收集自2000年7月至2009年3月期间的16家中国军队医院，并进行了回顾性分析。结果发现，2000年7月至2009年3月期间，共有7807例脾损伤患者入院（男性占84.32%，女性占15.68%）。平均住院时间为17.9±18.6天，连续几年脾损伤的性别分布无显著差异（P>0.05，c=0.034）。然而，不同月份脾损伤患者的性别分布存在显著差异（P<0.05，c=0.063）。此外，9月、10月和11月脾损伤的入院人数最多。还发现脾损伤可发生于各年龄段，不过工作年龄（20 - 50岁）的患者占85.59%，为所有记录病例中比例最高的。死亡率与每种治疗策略之间的关联如下：手术治疗为0.11%，非手术治疗为0.15%。此外，多因素分析表明输血、新损伤严重程度评分和治疗策略均与死亡率相关。因此，尽管缺乏来自民营医院住院患者的数据，但本研究部分确定了中国脾损伤的流行病学及治疗策略。这些发现可能补充了此前其他国家和地区对脾损伤分析的结果。
