【摘要】 目的了解本地区老年人跌倒致颅脑损伤流行病学情况,分析老年人跌倒并发重型颅脑损伤的危险因素。方法回顾性分析2013年1月1日—2014年12月31日南昌市青云谱区内跌倒、且经"120"送至南昌市区内各医院住院治疗的77例老年患者的临床资料,研究对象纳入标准:(1)年龄≥60岁;(2)有明确跌倒致头部外伤史;(3)初始CT扫描明确外伤性颅脑损伤。排除标准:(1)年龄<60岁;(2)不符合颅脑损伤诊断标准;(3)颅脑损伤非跌倒所致。对其相关单因素采用χ~2检验,将有意义的单因素纳入Logistic回归模型进行分析,统计软件采用SPSS17.0。结果单因素分析显示,老年人跌倒致重度颅脑损伤与性别、入院时间、跌倒平面、相关枕颞着地、心脑血管基础病有关(P<0.05),与年龄、合并伤无关(P>0.05)。进一步对相关因素Logistic回归分析显示,心脑血管基础病(OR=5.555)、相关枕颞部着地(OR=4.420)是老年人跌倒致重型颅脑损伤的高危因素。结论对有心脑血管基础病、相关枕颞着地的跌倒致颅脑伤老年患者应密切观察病情变化,把握时机,尽早进行积极干预,以控制危险因素,减少继发脑损伤,降低重型颅脑损伤的发生率,改善愈后。老年人跌倒的社区宣教应有颅脑损伤的相关知识,加强颅脑损伤知识的宣教,提高老年人对颅脑伤的认识,预防老年人跌倒致重型颅脑伤的发生是必要的。更多还原

【Abstract】 Objective To understand the epidemiology and risk factors of brain injury caused by falls in elderly people in this area. Methods The clinical data of 77 cases of senile severe head injury caused by falls in hospitals of Nanchang City between January 1,2013 and December 31,2014 were analyzed retrospectively. The criteria for the inclusion of patients:(1)aged 60 years or over;(2)there is a clear history of head injuries caused by falls;(3)the initial CT scanning clearly confirmed trauma craniocerebral damage. The criteria for the exclusion of patients:(1)the age of < 60 years old;(2)does not meet the diagnostic criteria for brain injury;(3)brain injury was not caused by falls. The related single factors were tested by χ2test,and the significant factors were entered into the Logistic regression model to analyze the statistical software by using SPSS 17. 0. Results Single factor analysis showed that severe craniocerebral injury caused by falls in the elderly correlated with gender,admission time,falls plane,landed on occipitotemporal sulcus,cardio cerebral vascular elementary disease( P < 0. 05),not with the age and associated injury( P > 0. 05). Logistic regression analysis showed that the cardiovascular disease( OR = 5. 555),landed on occipitotemporal sulcus( OR = 4. 420) were the high risk factors of severe brain injury caused by falls in the elderly. Conclusions For the old patients with severe head injury caused by falls,especially with cardio cerebral vascular elementary disease,we should observe closely the changes of condition,implement intervention as soon as possible,thereby control risk factors,reduce secondary brain injury and reduce the incidence of severe brain,improve the prognosis of patients. The community education should concern the contents of craniocerebral injury caused by falls,improve the understanding of the elderly to craniocerebral injury,and prevent the occurrence of severe brain injury.更多还原