Division of Neurosurgery, Department of Surgery, Federal Medical Center, Owo, Nigeria.
Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan and Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria.
World Neurosurg. 2020 Aug;140:e148-e152. doi: 10.1016/j.wneu.2020.04.205. Epub 2020 May 5.
Most of the few neurosurgeons in Nigeria are clustered in the urban centers. Consequently, a large proportion of the population who live in the rural areas have no direct access to neurosurgical care. This study aims to describe the burden of neurosurgical diseases in a rural neurosurgical service in Nigeria.
This was a prospective observational study of all neurosurgical patients managed at our center between August 2018 and July 2019. Data were analyzed with SPSS version 20 (IBM, Armonk, New York, USA).
The study cohort comprised 379 patients, including 267 males and 112 females (male:female ratio 2.4:1). The mean age was 35.71 ± 20.08 years (range, 35 hours to 100 years). More than one-half of the patients (55.6%) were age 20-49 years. Head injury was the most common presentation, occurring alone in 256 patients (67.55%) and in combination with spinal cord injury in 30 patients (7.92%). Brain tumors were present in 19 patients (5.01%), spinal cord injury in 15 patients (3.96%), degenerative spine disease in 9 patients (2.38%), and hydrocephalus in 5 patients (1.32%). Surgical intervention was performed in 21 patients (5.54%). The outcome of treatment was good in 251 patients (66.22%); 34 patients (8.97%) were referred to other facilities, 43 patients (11.35%) were discharged against medical advice, mostly because of economic reasons and poor medical insight, and 31 patients (8.18%) died.
Trauma is the most common indication for neurosurgical care in our service. Poverty and poor medical insight remain formidable obstacles to maximizing the benefits of available neurosurgical care in developing countries.
尼日利亚的神经外科医生数量较少，且大多集中在城市中心。因此，很大一部分居住在农村地区的人口无法直接获得神经外科治疗。本研究旨在描述尼日利亚农村神经外科服务中神经外科疾病的负担。
这是一项对 2018 年 8 月至 2019 年 7 月在我们中心接受治疗的所有神经外科患者进行的前瞻性观察性研究。使用 SPSS 版本 20（IBM，Armonk，纽约，美国）进行数据分析。
研究队列包括 379 名患者，其中 267 名男性和 112 名女性（男：女比例 2.4：1）。平均年龄为 35.71±20.08 岁（范围 35 小时至 100 岁）。超过一半的患者（55.6%）年龄在 20-49 岁之间。头部损伤是最常见的表现，单独出现于 256 例患者（67.55%），并与 30 例脊髓损伤患者（7.92%）同时存在。19 例患者存在脑肿瘤（5.01%），15 例患者存在脊髓损伤（3.96%），9 例患者存在退行性脊柱疾病（2.38%），5 例患者存在脑积水（1.32%）。对 21 例患者（5.54%）进行了手术干预。治疗结果良好的患者有 251 例（66.22%）；34 例（8.97%）被转介到其他机构，43 例（11.35%）因经济原因和较差的医疗意识而被建议出院，大多数患者出院，31 例（8.18%）患者死亡。
创伤是我们服务中神经外科治疗最常见的指征。贫困和较差的医疗意识仍然是发展中国家最大限度地受益于现有神经外科护理的巨大障碍。
