Kim Miri, Yoo Chung Bin, Lee-Park Owen, Nang Sam, Vuthy Din, Park Kee B, Vycheth Iv
Department of Neurosurgery, Loyola University Medical Center, Maywood, IL, USA.
Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia.
Asian J Neurosurg. 2020 Sep 2;15(4):952-958. doi: 10.4103/ajns.AJNS_213_20. eCollection 2020 Oct-Dec.
Low- and middle-income countries (LMICs) have a growing and largely unaddressed neurosurgical burden. Cambodia has been an understudied country regarding the neurosurgical pathologies and case volume. Rapid infrastructure development with noncompliance of safety regulations has led to increased numbers of traumatic injuries. This study examines the neurosurgical caseload and pathologies of a single government institution implementing the first residency program in an effort to understand the neurosurgical needs of this population.
This is a longitudinal descriptive study of all neurosurgical admissions at the Department of Neurosurgery at Preah Kossamak Hospital (PKH), a major government hospital, in Phnom Penh, Cambodia, between September 2013 and June 2018.
5490 patients were admitted to PKH requiring neurosurgical evaluation and care. Most of these admissions were cranial injuries related to road traffic accidents primarily involving young men compared to women by approximately 4:1 ratio. Spinal pathologies were more evenly distributed in age and gender, with younger demographics more commonly presenting with traumatic injuries, while the older with degenerative conditions.
Despite increased attention and efforts over the past decade, Cambodia's neurosurgical burden mirrors that of other LMICs, with trauma affecting most patients either on the road or at the workplace. Currently, Cambodia has 34 neurosurgeons to address the growing burden of a country of 15 million with an increasing life expectancy of 69 years of age, stressing the importance of better public health policies and urgency for building capacity for safe and affordable neurosurgical care.
低收入和中等收入国家（LMICs）的神经外科负担日益加重，且在很大程度上未得到解决。柬埔寨在神经外科病理学和病例数量方面一直是一个研究较少的国家。快速的基础设施发展加上安全法规执行不力，导致创伤性损伤数量增加。本研究调查了一家实施首个住院医师培训项目的政府机构的神经外科病例数量和病理情况，以了解该人群的神经外科需求。
这是一项对柬埔寨金边主要政府医院——波列·科斯马医院（PKH）神经外科2013年9月至2018年6月期间所有神经外科住院病例的纵向描述性研究。
5490名患者因需要神经外科评估和治疗而入住PKH。这些住院病例大多是与道路交通事故相关的颅脑损伤，主要涉及年轻男性，男女比例约为4:1。脊柱疾病在年龄和性别上分布更为均匀，较年轻人群更常见创伤性损伤，而老年人则以退行性疾病为主。
尽管在过去十年中受到了更多关注并做出了努力，但柬埔寨的神经外科负担与其他低收入和中等收入国家相似，创伤影响着大多数在路上或工作场所的患者。目前，柬埔寨有34名神经外科医生，要应对一个1500万人口且预期寿命不断增加至69岁的国家日益加重的负担，这凸显了更好的公共卫生政策的重要性以及建设安全且负担得起的神经外科护理能力的紧迫性。
