創傷性脊髓損傷之城鄉比較
創傷性脊髓損傷是許多造成人類殘障的疾病中，對生命摧殘得最厲害的一種災難，患者
一旦發生損傷將對其本身、家庭皆造成嚴重影響。過去各國研究中顯示，創傷性脊髓損 傷患者之發生率、受傷年齡、性別分佈與受傷原因等因子在城鄉間是存在著差異的，因 此評估適用該區域的預防措施是相當重要的。本研究為台灣地區首篇針對創傷性脊髓損 傷城鄉差異之研究，目的係探討城鄉間患者各相關因子之差異情形，並進一步分析危險 因子與病患嚴重程度的相關性。
本研究對象包括自 2004/7/1 至 2007/6/30 三年間由「中華民國頭脊髓外傷研究小組」創 傷性脊隨損傷資料庫所收集之因創傷性脊髓損傷至台北市及花蓮縣 22 家合作醫院治療 之患者，共有 777 人。以 t 檢定來檢驗台北市與花蓮縣兩組間之連續變項資料有無差異
，以卡方檢定 (Chi-Square) 檢驗其類別變項之差異，並進一步以邏輯式迴歸分析危險因 子與病患嚴重程度之相關性。
結果顯示城鄉研究對象分別為台北市 664 位、花蓮縣 113 位創傷性脊隨損傷患者。在年 齡、受傷原因、送醫方式、送醫時間及住加護病房天數部分兩地皆無顯著差異，而在性 別、脊髓受傷部位、合併傷害、神經障礙分類中兩地區則是達到統計上顯著差異。且有 無合併傷害以及脊髓受傷部位會顯著影響病患出院時神經障礙嚴重程度之風險。
根據本文的結果顯示，創傷性脊髓損傷者的神經障礙種類等各項傷害特徵在城鄉間存在
差異，尤其在性別、受傷嚴重度及神經障礙情形特別明顯，因此建議未來應進一步發展 適用於城鄉特性之傷害防治措施，以確實降低創傷性脊髓損傷之風險。
Comparison of traumatic spinal cord injury between urban and rural area
Traumatic spinal cord injury is the most catastrophic disease that causes not only disability for the individual but also tragic disaster towards the family. From past research, the incidence, ag e, sex and cause for traumatic spinal cord injury are significantly different between urban and rural areas. Therefore it is important to further evaluate preventive measures of spinal cord inj ury for the specific area. This is a pilot study, which focus on the comparison of spinal cord inj ury between urban and rural areas. The purpose of this study is to analyze the different risk fac tors between urban and rural areas and the relationship between risk factor and severity of inju ry.
All patients were selected from the National Head and Spinal Cord Injury Team’s research dat abank. 777 traumatic spinal cord injury patients were recruited to enroll into this study betwee n July 01, 2004 and June 30, 2007. Furthermore, patients were all from 22 hospitals in Taipei and Hualien County. We use t-test to examine whether there was any difference of continuous variety between the data from Taipei vs. Hualien County. Additionally, we use Chi-Square tes t to examine the difference of categorical variable. Lastly, logistic regression was applied to in vestigate the correlation between risk factors and injury severity.
The results showed that there were 664 patients in Taipei and 113 patients are from Hualien C ounty. However, there was no statistic difference in age, the cause of injury, way of
Comparison of traumatic spinal cord injury between urban and rural area
transport to hospital, time of transportation, and days of hospitalization bet ween these 2 areas. Nevertheless, the variable of sex, the part of spinal cor d injured, complication and neurological deficits did show significant diffe rence between the 2 areas. Also, the part of spinal cord injured and whether there were other complications had a significant effect on the patients’ neur ological deficit level when discharged from the hospital
