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欧洲一级创伤中心5026例周围神经损伤的流行病学及病因分析

An Epidemiological and Etiological Analysis of 5026 Peripheral Nerve Lesions from a European Level I Trauma Center.

作者信息

Aman Martin, Zimmermann Kim S, Thielen Mirjam, Thomas Benjamin, Daeschler Simeon, Boecker Arne H, Stolle Annette, Bigdeli Amir K, Kneser Ulrich, Harhaus Leila

机构信息

Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand-and Plastic Surgery, University of Heidelberg, 69117 Heidelberg, Germany.

出版信息

J Pers Med. 2022 Oct 8;12(10):1673. doi: 10.3390/jpm12101673.

Abstract

BACKGROUND

Peripheral nerve lesions are associated with debilitating long-term consequences. Albeit being essential for evidence-based clinical decision making, epidemiological and etiological data are scarce. We therefore aimed to comprehensively analyze epidemiological and etiological factors of peripheral nerve lesions in one of the largest cohorts.

METHODS

We screened a total of 110,667 patients treated at our level I trauma center between January 2012 and July 2020 for nerve lesions. Subsequently, demographics, etiologies, concomitant injuries, and lesion characteristics were analyzed.

RESULTS

A total of 5026 patients, predominantly young males suffering from non-work-related nerve injuries, were treated. Proximal levels of injury were more likely to be accompanied by fractures, whereas more distal injuries with concomitant vessel or tendon injury. Main causes were 54.6% lacerations. Acute traumatic nerve injury was treated within 24 h in 55.9% of cases.

CONCLUSIONS

Given the young age of affected patients, early diagnosis and treatment in specialized centers may facilitate their early return to work and improve long-term functional outcomes. The data show the importance of a special attention on nerve injuries, which may be masked by large accompanying injuries. New findings on lesion characteristics of selected subgroups and accompanying circumstances can support a change in treatment strategies.

摘要

背景

周围神经损伤会导致长期的功能障碍。尽管流行病学和病因学数据对于循证临床决策至关重要,但相关数据却很匮乏。因此,我们旨在对一个大型队列中的周围神经损伤的流行病学和病因学因素进行全面分析。

方法

我们对2012年1月至2020年7月期间在我院一级创伤中心接受治疗的110667例患者进行了神经损伤筛查。随后,对患者的人口统计学特征、病因、合并伤以及损伤特征进行了分析。

结果

共治疗了5026例患者,其中以非工作相关神经损伤的年轻男性为主。近端损伤更易伴有骨折,而远端损伤则更易合并血管或肌腱损伤。主要病因是54.6%的撕裂伤。55.9%的急性创伤性神经损伤在24小时内得到治疗。

结论

鉴于受影响患者的年龄较轻,在专科中心进行早期诊断和治疗可能有助于他们早日重返工作岗位,并改善长期功能预后。数据表明,对神经损伤给予特别关注非常重要,因为神经损伤可能会被严重的合并伤所掩盖。特定亚组的损伤特征和伴随情况的新发现可以支持治疗策略的改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/732d/9605203/e680fe0bd632/jpm-12-01673-g001.jpg

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