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高收入发展中国家的儿科创伤性脑损伤:1 级神经创伤中心的经验。

Pediatric traumatic brain injury in a high-income developing country: experience at a level 1 neuro-trauma center.

机构信息

College of Medicine & Health Science, National University of Science & Technology, P.O. Box 391, P.C 321 Sohar, Sultanate of Oman.

College of Medicine and Health Sciences, Sultan Qaboos University, Al Koudh, Box 35 SQU, 123, Seeb, Oman.

出版信息

J Trop Pediatr. 2022 Dec 5;69(1). doi: 10.1093/tropej/fmac104.

Abstract

BACKGROUND

Data on the incidence, prevalence and mortality of pediatric traumatic brain injuries (TBIs) in developing countries are not readily available or do not exist.

AIM

The aim of this study was to study the epidemiology of pediatric TBI in developing countries.

METHODS

A retrospective study was conducted in a high-volume Neurosurgery Department where we reviewed pediatric cases presenting with TBI between January 2015 and December 2019. Data were collected from the electronic medical records including the patients' demographics, neuro-vital signs, mechanism of TBI and treatment types. Radiological images were screened, and patients were classified according to the type of intracranial hemorrhage. The patient's outcome and Glasgow Coma Scale on discharge were also recorded.

RESULT

Nine hundred and eighty-five cases with TBI were admitted over the period of 5 years. The average age was 53.3 months standard deviation (SD) of 39.4. Male gender accounted for 63.7% of the cases. The most common mechanisms of injuries were falls and road traffic accidents/motor vehicle collisions (63.3%, 18.3%), respectively. Nausea and vomiting followed by altered consciousness and drowsiness were the commonest presenting symptoms. Mild TBI accounted for 85.2% of the cases and the majority (92.08%) were treated conservatively (P < 0.005). 93.3% of the cases were categorized as mild head injury upon discharge. The mortality rate was 1.6% in severe TBI cases.

CONCLUSION

Children less than 4 years of age were highly affected by TBI. This study gives emergency physicians and neurosurgeons in developing countries an expectation about TBI in pediatric cases and the immediate management to prevent further complications.

摘要

背景

发展中国家有关儿童创伤性脑损伤(TBI)的发病率、患病率和死亡率的数据尚不可用或不存在。

目的

本研究旨在研究发展中国家儿科 TBI 的流行病学。

方法

我们对一家高容量神经外科部门进行了回顾性研究,在此期间,我们对 2015 年 1 月至 2019 年 12 月期间因 TBI 就诊的儿科病例进行了回顾。数据从电子病历中收集,包括患者的人口统计学、神经生命体征、TBI 机制和治疗类型。筛选影像学图像,并根据颅内出血类型对患者进行分类。还记录了患者的结局和出院时的格拉斯哥昏迷量表评分。

结果

在 5 年期间,共收治了 985 例 TBI 患者。平均年龄为 53.3 个月,标准差为 39.4。男性占病例的 63.7%。最常见的损伤机制分别是跌倒和道路交通伤害/机动车碰撞(分别为 63.3%和 18.3%)。恶心和呕吐,其次是意识改变和嗜睡,是最常见的症状。轻度 TBI 占病例的 85.2%,大多数(92.08%)采用保守治疗(P<0.005)。出院时 93.3%的病例被归类为轻度头部损伤。重度 TBI 病例的死亡率为 1.6%。

结论

4 岁以下儿童受 TBI 的影响最大。本研究为发展中国家的急诊医师和神经外科医师提供了儿科 TBI 的预期,并提供了立即管理以预防进一步并发症的方法。

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