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目的:调查分析8所军队医院军人非战时颅脑损伤(TBI)的临床特征,探讨相关的卫勤保障对策。方法:回顾性分析8所军队医院2002—2012年住院非战时TBI军人患者的临床资料。结果:(1)军人TBI 668例中,轻型448例(67.1%),中型154例(23.1%),重型62例(9.3%)·特重型4例(0.6%);转诊427例(63.9%),其中初诊单位为卫生队193例(28.9%)、地方医院156例(23.3%),均转诊到军队体系医院;二次转诊57例(8.5%)。(2)受伤原因:摔伤355例(53.1%),打击伤143例(21.4%),交通事故伤85例(12.7%),高处坠落伤85例(12.7%);训练伤175例(26.2%)。军官和士官交通事故伤占比均显著高于士兵(P<0.05),而士兵和士官高处坠落伤占比均显著高于军官(P<0.05);士兵和士官的训练伤均显著高于军官(P<0.05)。(3)转诊病例中,中型和重型TBI者均显著高于未转诊病例(P<0.05);二次转诊病例中,中型TBI者显著高于其他病例(P<0.05)。结论:针对性制定军人TBI预防措施;加强基层部队救治能力建设;通过军民融合式发展提升军人TBI的防治水平。
Objective: To investigate and analyze the clinical characteristics of non-war TBI in 8 army hospital soldiers and to explore the related health care countermeasures. Methods: We retrospectively analyzed the clinical data of non-war TBI soldiers in 8 military hospitals from 2002 to 2012. Results Among the 668 TBI cases, 448 (67.1%) were mild, 154 (23.1%) were moderate, 62 (9.3%) were heavy and 4 (0.6% %). Among them, 193 cases (28.9%) were initially diagnosed as health teams and 156 cases (23.3%) were local hospitals. All were referred to the military hospital; 57 cases (8.5%) were referred to secondary hospitals. There were 355 cases (53.1%) of injury, 143 cases (21.4%) of injury, 85 cases (12.7%) of accidental injuries and 85 (12.7%) cases of fall injury. Training injuries ranged from 175 26.2%). The occupational injury rate of officers and non-commissioned officers was significantly higher than that of soldiers (P <0.05), while the occupational injuries of soldiers and non-commissioned officers were significantly higher than those of officers (P <0.05); the training injuries of soldiers and non-commissioned officers were significantly higher than those of soldiers Military officer (P <0.05). (3) Among the referral cases, the medium and heavy TBI were significantly higher than those without referral (P <0.05). In the second referral, the medium TBI was significantly higher than the other cases (P <0.05). Conclusion: Targeting military TBI prevention measures; strengthen the grass-roots unit treatment capacity building; through military and civilian integration development to enhance the prevention and treatment of military TBI.