Blond McIndoe Laboratories, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PT, UK; Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK.
Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK.
J Plast Reconstr Aesthet Surg. 2023 May;80:75-85. doi: 10.1016/j.bjps.2023.02.017. Epub 2023 Feb 16.
Peripheral nerve injury (PNI) is a significant health problem that confers lifelong impact on those injured. Current interventions are purely surgical; however, outcomes remain poor. There is a lack of high-quality epidemiological data that is needed to identify populations involved, current healthcare demands, and ensure resources are distributed to the greatest effect, to reduce the injury burden.
Anonymized hospital episode statistical (HES) data on admitted patient care was obtained from NHS Digital for all National Health Service (NHS) patients sustaining PNI of all body regions between 2005 and 2020. Total numbers of finished consultant episodes (FCEs) or FCEs/100,000 population were used to demonstrate changes in demographic variables, anatomical locations of injury, mechanisms of injury, speciality, and main operation.
There was a mean national incidence of 11.2 (95% CI 10.9, 11.6) events per 100,000 population per year. Males were at least twice as likely (p < 0.0001) to sustain a PNI. Upper limb nerves at or distal to the wrist were most commonly injured. Knife injuries increased (p < 0.0001), whereas glass injuries decreased (p < 0.0001). Plastic surgeons increasingly managed PNI (p = 0.002) as opposed to orthopaedic surgeons (p = 0.006) or neurosurgeons (p = 0.001). There was an increase in neurosynthesis (p = 0.022) and graft procedures (p < 0.0001) during the study period.
PNI is a significant national healthcare problem predominantly affecting distal, upper limb nerves of men of working age. Injury prevention strategies, improved targeted funding and rehabilitation pathways are needed to reduce the injury burden and improve patient care.
周围神经损伤（PNI）是一个重大的健康问题，会对受伤者造成终身影响。目前的干预措施纯粹是手术性的；然而，结果仍然很差。缺乏高质量的流行病学数据来确定涉及的人群、当前的医疗保健需求，并确保资源得到最大程度的分配，以减轻伤害负担。
从 NHS Digital 获得了 2005 年至 2020 年间所有因身体各部位 PNI 而住院的 NHS 患者的匿名医院发病统计（HES）数据。使用总会诊次数（FCE）或 FCE/每 10 万人的数量来展示人口统计学变量、损伤解剖位置、损伤机制、专科和主要手术的变化。
全国平均发病率为每年每 10 万人中有 11.2 例（95%CI 10.9，11.6）。男性发生 PNI 的可能性至少是女性的两倍（p<0.0001）。腕部或腕部以下的上肢神经最常受伤。刀伤增加（p<0.0001），而玻璃伤减少（p<0.0001）。整形外科医生越来越多地管理 PNI（p=0.002），而不是骨科医生（p=0.006）或神经外科医生（p=0.001）。研究期间，神经缝合术（p=0.022）和移植物手术（p<0.0001）有所增加。
PNI 是一个重大的国家医疗保健问题，主要影响到处于工作年龄的男性的远端上肢神经。需要预防策略、有针对性的资金改善和康复途径，以减轻伤害负担并改善患者护理。
