张 浩,刘 宇,肖世宁,张 钰,刘志礼,刘家明.中国创伤性脊髓损伤患者流行病学特征的Meta分析[J].中国脊柱脊髓杂志,2023,(5):397-407. |
中国创伤性脊髓损伤患者流行病学特征的Meta分析 |
中文关键词: 创伤性脊髓损伤 流行病学 Meta分析 |
中文摘要: |
【摘要】 目的:通过Meta分析对中国创伤性脊髓损伤(traumatic spinal cord injury,TSCI)患者的流行病学特征进行评价。方法:计算机检索PubMed、The Cochrane Library、Web of TSCIence、万方数据、维普网(vip citation databases,VIP)和中国知网(China national knowledge infrastructure,CNKI),检索时限均从2017年8月31日~2023年2月28日,收集有关中国地区TSCI流行病学特征及相关并发症和合并伤的研究,对文献所报道的TSCI发病率、年龄特征、男女比例、病因学占比、损伤节段和损伤程度等数据进行提取。由2名研究人员独立检索与筛选文献、提取文献数据,并对纳入研究的文献按照AHRQ(Agency for Healthcare Research and Quality)横断面研究评价标准进行质量评价。采用 Stata 17.0 软件进行单臂研究数据的Meta分析,整合纳入文献中的各项流行病学数据,分析结果由森林图表示。结果:共纳入符合标准的中英文文献21篇,对文献中报道的TSCI患者数据进行Meta合并分析,结果显示,我国TSCI年发病率为0.06‰[95%CI(0.04‰~0.08‰)]。TSCI男性患者多于女性患者,性别比例为(1.86~4.73)∶1,所有患者的平均年龄范围为32.09~53.92岁。中国TSCI的主要病因是高处坠落、交通事故和低处跌倒,其占比分别为30%、31%和25%。中国TSCI患者的主要损伤部位是颈段和胸段,占比分别为55%和21%。TSCI损伤的严重程度按照ASIA分级进行评定,以A级和D级损伤占比最大,分别为30%和38%。中国TSCI患者伴随合并伤的概率为56%[95%CI(45%~67%)],主要是头部损伤和肢体骨折。TSCI后产生并发症的概率31%[95%CI(24%~38%)],以呼吸系统感染和泌尿系感染为主。结论:当前中国TSCI发病率偏高,跌倒和交通事故是其主要病因。损伤节段以颈段为主,损伤程度以ASIA A级和ASIA D级占比最多。超过半数的患者会有身体其他部位的合并伤,近1/3的患者会在TSCI后产生并发症。 |
Epidemiological characteristics of traumatic spinal cord injury in China: a meta-analysis |
英文关键词:Traumatic spinal cord injury Epidemiology Meta-analysis |
英文摘要: |
【Abstract】 Objectives: To evaluate the epidemiological characteristics of traumatic spinal cord injury(TSCI) in China by meta-analysis. Methods: PubMed, The Cochrane Library, Web of TSCIence, Wanfang databases, VIP citation databases(VIP) and China national knowledge infrastructure(CNKI) were searched to retrieve studies published from August 31, 2017 to February 28, 2023. Studies on the epidemiological characteristics of TSCI in China and related complications and combined injuries were collected. Data such as incidence, age, male/female ratio, etiology proportion, injury segment and injury degree were extracted. Two researchers independently searched and screened the literature, extracted data, and evaluated the quality of the literature included in the study according to AHRQ(Agency for Healthcare Research and Quality) cross-sectional study evaluation criteria. Stata 17.0 software was used for a meta-analysis of single arm research data and integrating various epidemiological data, and the analysis results were represented by forest maps. Results: A total of 21 Chinese and English literature were included. Meta-analysis results showed that the annual incidence of TSCI in China was 0.06‰[95%CI(0.04‰-0.08‰)], males were more than females with a gender ratio of (1.86-4.73)∶1, and the average age of patients was 32.09-53.92 years old. The main causes of TSCI in China were high fall(30%), traffic accident(31%), and low fall(25%). The main injury sites of TSCI patients in China were cervical(55%) and thoracic(21%) segments. The severity of TSCI damage was more of grade A(30%) and grade D(38%) as assessed according to the American Spinal Injury Association(ASIA) classification. The probability of combined injuries in Chinese TSCI patients was 56%[95%CI(45%-67%)], including mainly head injuries and limb fractures. The probability of complications after TSCI was 31%[95%CI(24%-38%)], mainly respiratory system infection and urinary system infection. Conclusions: At present, the incidence rate of TSCI in China is high, and low falls and traffic accidents are the main causes. The damaged segment is mainly the cervical segment, and ASIA grade A and grade D account for the most. More than half of the patients have combined injuries to other parts of the body, and nearly 1/3 of the patients have complications after TSCI. |
投稿时间:2022-12-05 修订日期:2023-03-14 |
DOI: |
基金项目:江西省“双千计划”首批培养类项目;江西省重点研发计划(No. 20222ZDH04095,20223BBG71S02) |
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