Fluid and nutritional management in severe head injuries

Fluid management, electrolyte balance and nutritional support had been examined for 14 days in 39 patients of severe head injury under intracranial pressure (ICP) monitoring. When ICP value exceeded 25 mmHg, barbiturate was administered in addition to the conventional therapy. Restriction of fluid administration should depend upon ICP values. When the ICP value was 20 mmHg or less and basal cisterns or ventricular systems were not obliterated in serial CT scan, fluid administration was not restricted in most patients. Mean urine volume was measured 2500 ml/day and mean water balance was measured about 0 to 700 ml/day with large deviation. Urine output and specific gravity was checked every hour and water balance was evaluated every day. When excess urine output or dehydration was recognized, additional fluid was given to keep within 500 ml/day in water balance. Through the examination, no patients of dehydration nor azotemia were experienced. Out of 39, 22 were survived and 17 were expired. In expired patients, 13 patients was recognized dead or brain death within 72 hours of injury. In two patients (one is suffered from severe brainstem injured patient with corpus callosal hemorrhage and another patient with post operative cerebral swelling) cerebral herniation was recognized about 72 hour after injury. Remaining 2 patients died after 7 days. Patients with hypernatremia were recognized 3 (13.7%) out of 22 survivals, and 14 (82.4%) out of 17 expired patients. It was recognized more common within 3 days of injury. Hypernatremia more than 160 mEq/l was accounted 5 (29.4%) in expired patients, but non in survivals.(ABSTRACT TRUNCATED AT 250 WORDS)     

Barbiturate therapy for patients with refractory intracranial hypertension following severe traumatic brain injury: its effects on tissue oxygenation, brain temperature and autoregulation.

The aim of this study was to explore the effects of barbiturate coma on cerebral tissue oxygen tension and cerebrovascular pressure reactivity (PRx), as an index of cerebral autoregulation in severe head injury patients. This was a prospective observational clinical study of 12 patients with severe traumatic brain injury, carried out at a tertiary-level neurosurgical intensive care unit between April 2002 and May 2005. All patients received standard neurosurgical intensive care and monitoring. Probes for intracranial pressure (ICP), brain temperature (BT) and brain tissue oxygenation (PTiO2) were inserted into (noncontused) normal-looking white matter. Cerebrovascular PRx was measured as a moving correlation between ICP and arterial blood pressure. Barbiturate coma was instituted when ICP became refractory (ICP>20 mmHg). All data from the multimodal monitoring were digitally extracted and statistically analysed. The mean ICP decreased with barbiturate coma in eight of the 12 patients (75% of the patients), but only four achieved a value below 20 mmHg. Of eight patients with prebarbiturate PTiO2 levels above 10 mmHg, six had a further improvement in oxygenation. Thus, concordant favourable changes in ICP, PRx and PTiO2 with barbiturate coma were seen in those who survived. Effective response to barbiturates can be detected by improved PTiO2 and autoregulation (PRx) in severe head injury patients.     

显微外科治疗重型脑干出血

目的探讨显微外科治疗重型脑干出血的指征、手术方法和效果。方法回顾性分析2006年2月至2010年4月显微手术治疗的34例出血量5~18ml、GCS评分4~7分的重型脑干出血病人的临床资料。结果 34例经36次显微手术全部清除血肿,其中16例经颞下锁孔开颅手术。术后7d内清醒4例,其中2例GCS评分5分的患者,术后第2天即恢复部分意识。术后死亡3例。31例随访6月~3年,生活能自理4例,部分自理9例,清醒但重残5例,微弱意识2例,植物生存5例,死亡6例。结论早期应用显微手术清除血肿,加强围手术期的综合处理,可明显改善重型脑干出血患者的预后。     

Prognostic implications of hyperglycaemia in paediatric head injury

Fifty children with head injury were evaluated in an attempt to estabilish a correlation between post-traumatic hyperglycaemia and long-term outcome. In all the patients, the blood glucose level was measured on admission and on the days following the trauma (threshold of normal value set at 150 mg/dl). Hyperglycaemia was seen more frequently in children with severe head injury than in those with mild and moderate head injury. It was present in 87.5% of the patients with a Glasgow Coma Score (GCS) ≤8 (the average blood glucose level on admission was 237.8±92 mg/dl), in 60% of the patients with a GCS of 9–12 (178±78.7 mg/dl) and only in 25% of those with a GCS of 13–15 (131.5±39 mg/dl). A close correlation was also seen between the outcome and the blood glucose level. In fact, the blood glucose on admission was higher in the patients with a poor outcome, i.e. in those having a Glasgow Outcome Score (GOS) of 2 or 3 and in those who died (GOS 1), than in the patients with a good outcome (GOS of 4 or 5). Finally, hyperglycaemia persisted beyond the first 24 h after trauma in all the children who died or who survived with a poor outcome. Hyperglycaemia, and especially its persistence over time, appears to be an important negative prognostic factor in children with head injury. Received: 14 May 1998     

Measurement of energy expenditure in the acute stage of head injury (Part I)

Oxygen consumption (VO2), carbon dioxide production (VCO2), resting metabolic expenditure (RME), RME of that expected for an uninjured resting person of equivalent age, sex, and body surface area (RME%), nitrogen balance, and protein calorie contribution (PCC) were measured in 8 patients with head injury. Metabolic measurements were carried out with the technique of indirect calorimetry from onsets to 14th day. Mean values of VO2 and VCO2 were 298 ml/min, 236 ml/min respectively on admission and those decreased gradually. Mean values of RME%, nitrogen balance, and PCC were 130.6%, -14.5 gm/day, and 17.3% respectively on admission. And those three values significantly decreased on 14th day in those 8 patients. From those facts, it was implied that hypermetabolism and hypercatabolism existed, and measurement of energy expenditure was indispensable to supply enough calorie maintaining body weight and immunocompetence in the acute stage of head injury.     

Increase of energy expenditure in Parkinson's disease

Energy expenditure was determined in 18 patients with Parkinson's disease, 6 healthy volunteers and 6 patients with essential tremor, age-matched, using the indirect calorimetric method which measures the gas exchange rate. The results showed a significant increase in the relative energy expenditure, i.e. the difference between absolute and predictable values from the Harris and Benedict equation, among the parkinsonian patients (+21 +/- 4.1 p. 100; mean +/- S.E.M.) as compared to the 2 control groups (-8.6 +/- 7 p. 100 and -2.1 +/- 4.1 p. 100 respectively; p less than 0.001). There was no correlation between the rate of energy expenditure and the duration or degree of severity of the disease, and particularly the occurrence and magnitude of weight loss, which is frequently observed during the course of the disease. The relative energy expenditure was not significantly different between untreated and treated parkinsonian patients (18.8 +/- 3 p. 100 and 24.5 +/- 6.2 p. 100 respectively). Further investigations were designed to determine whether the increased energy expenditure could reflect a functional impairment of the automatic nervous system. The integrity of the vagus nerve was tested by plotting vs time the plasma Pancreatic Polypeptide levels in response to insulin-induced hypoglycaemia. A physiological stimulation was obtained in the 8 parkinsonian patients studied. This is not the case in chronic autonomic failure. On the contrary, the relative energy expenditure was significantly decreased in the 6 patients that were given a beta-blocking drug, pindolol, 15 mg daily for 3 weeks (+30.7 +/- 4.3 p. 100 before and +21 +/- 4.2 p. 100 after treatment; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

一次和多次住院精神分裂症患者再住院分析

目的 :比较 1次和≥ 2次住院精神分裂症患者出院后的再住院率 ,初步探讨影响再住院的相关因素。　方法 :1999年度出院的 833例住院精神分裂症患者纳入调查 ,使用自制的再住院及其相关因素调查表 ,于 2 0 0 3年 12月底前电话或入户调查出院后至少 4 8个月的情况。　结果 :6 6 4例完成调查 ,分为 1次住院组 (333例 )和多次住院组 (331例 )。用生存分析 (Kaplan Meier公式 )比较两组未再住院率 ,12个月末 (分别为 6 7 0 %和 6 1 6 % )、2 4个月末 (5 6 2 %和 4 8 9% )、36个月末 (4 6 0和 35 1% )和 4 8个月末 (4 1 1%和 2 8 7% )。Cox回归风险比例模型分析影响再住院的相关因素显示 ,与药物依从性、生活事件、自知力和家庭照顾相关 (P <0 0 5 ) ,药物依从性对再住院的贡献值 (1 719)最大。　结论 :1次住院精神分裂症患者出院后的再住院率较多次住院者低。药物依从性是影响再住院的主要因素     

胱抑素C水平与急性缺血性脑卒中患者血管内治疗效果的相关性分析

目的 探讨血清胱抑素C(Cystatin C,Cys C)水平对接受血管内治疗的急性缺血性脑卒中患者预后的预测价值。方法 回顾性分析125例接受血管内治疗的急性缺血性脑卒中患者的临床资料,记录相关病史及实验室检验指标水平; 对所有符合血管内治疗标准的急性缺血性脑卒中患者依据美国国立卫生研究院卒中量表(National institutes of health stroke scale,NIHSS)进行神经功能缺损评分; 出院3个月后依据改良Rankin量表(modified rankin scale,mRS)对所有患者进行神经功能评分,依据mRS评分分为2组,mRS评分≤2分为预后良好组,mRS评分>2分为预后不良组,分别比较2组患者的一般资料和手术治疗,并采用Logistic 回归分析确定接受血管内治疗的急性缺血性脑卒中患者预后的不良因素,用受试者工作特征(Receiver operator characteristic,ROC)曲线评估Cys C水平对接受血管内治疗的急性缺血性脑卒中患者的预后不良的预测价值。结果 预后良好组59例,预后不良组66例。预后不良组APTT(Activated partial thromboplastin time,APTT)、入院时Cys C水平、入院时NIHSS评分和年龄较预后良好组高(P<0.05)。多因素Logistic回归分析结果显示入院时NIHSS评分、入院时血清Cys C水平、接受静脉溶栓和APTT水平是接受血管内治疗的急性缺血性卒中患者预后不良的独立危险因素。入院时血清Cys C水平对接受血管内治疗的急性缺血性卒中预后不良的诊断界值为1.005,其敏感度为62.1%,特异度为71.2%,准确度为66.4%。结论 入院时血清Cys C水平对接受血管内治疗的急性缺血性脑卒中患者的不良预后有良好的预测价值,血清Cys C水平越高,预后越差。     

Cerebral deep vein thrombosis: three cases]

Cerebral internal venous thrombosis are rare and diagnosis is difficult. We report three cases in male adults. Clinical data were headaches, vomiting, dizziness and coma, in relation with an intracranial hypertension, or in a case, cardiocirculatory arrest. Cerebral internal veinous thrombosis was diagnosed by a CT scan and cerebral angiography twenty four hours after the admission in neurosurgical intensive care. CT scan showed hemorrhagic and ischemic lesions of thalami in two cases, diffuse cerebral edema in two patients, early or delayed hydrocephaly in two cases. No patient survived despite intensive treatment including heparinotherapy, ventricular CSF drainage, osmotherapy, dehydration, barbiturate, other antiepileptic drugs and mechanical ventilation. In two cases, general or local illness was found, sickle cell disease or radiotherapy for pineal tumor, and in case 3 clinical signs evoked autoimmune disease, not demonstrated by biological samples.     

Cranial computed tomography in purulent meningitis of childhood

The cranial computed tomography (CT) findings of 48 children with purulent meningitis were examined, prospectively, to determine the importance of cranial CT findings on the prognosis of childhood meningitis, in a developing country. The age of children ranged from 2 months to 13 years. Of 48 patients, 29 (60.5%) survived without sequelae, 13 (27%) survived with sequelae, and six (12.5%) died. Cranial CT was normal in 21 (43%) patients of 48 children with meningitis at admission. Abnormal CT findings were detected in 10, 11, and 6 children in the groups of survived without sequelae, survived with sequelae, and deaths, respectively, at admission (p <.05) We found that CT scan results were correlated with neurological signs (p <.05). At least one or more cranial CTs were was re-taken in children in whom the first CT revealed abnormal findings; we did not find a statistically significant difference for the follow-up CT findings between the groups (p >.05). Hydrocephalus and subdural effusion were the commonest abnormal CT findings. In conclusion, our findings showed that cranial CT may safely be used to detect intracranial complications of meningitis in childhood and the ratio of sequelae and death were more common in children with abnormal cranial CT than those of normal cranial CT findings. Additionally, there was a positive correlation between CT scan results and neurological signs.     

Severe hypokalemia and rebound hyperkalemia during barbiturate coma in patients with severe traumatic brain injury

ObjectivesTo evaluate the incidence of severe potassium disturbances during barbiturate coma therapy in patients with severe traumatic brain injury (TBI), and the characteristics of these patients.MethodsThe study comprised 37 patients with severe TBI who were treated for barbiturate coma between 2015 and 2017 in level 3 intensive care units of two hospitals.ResultsNo potassium disturbance occurred in 14 patients. Seventeen patients developed mild-moderate hypokalemia (2.6–3.5 mEq/L), and 6 patients developed severe hypokalemia (<2.5 mEq/L) following the induction of barbiturate therapy. The incidence of mild-to-severe barbiturate-induced hypokalemia was 62.2% and the rate of severe hypokalemia was 16.2%. The mean potassium supply per day during thiopentone therapy was statistically significantly different between patients with mild-to-moderate hypokalemic and those with severe hypokalemic (p < 0.001). Four of 6 patients with severe hypokalemia developed rebound hyperkalemia exceeding 6 mEq/L following the cessation of barbiturate infusion. The nadir potassium concentration was 1.5 mEq/L and the highest value was 6.8 mEq/L. The mean time to reach nadir potassium concentrations was 2.8 days. The mortality rate of the 6 patients was 66.7%. Of the 2 survivors of severe hypokalemia, the Glasgow Outcome Scale (GOS) on discharge and the extended GOS one year after the trauma were 5 and 8 respectively.ConclusionsSevere hypokalemia refractory to medical treatment and rebound hyperkalemia is a serious adverse effect of thiopentone coma therapy in patients with severe TBI. Excessive and aggressive potassium replacement during the barbiturate-induced hypokalemia period must be avoided. Weaning barbiturate treatment over time may be advantageous in the management of severe serum potassium disturbances.     

Editorial: Putting a new face on paediatric rehabilitation

We report about 38 patients aged between 1 and 19 years (36·8% female, 63·2% male; mean age 7·8 years) admitted as inpatients for further neurorehabilitation mostly 4 weeks after severe acquired brain injury (ABI) of different aetiology. Of the patients, 73·7% were in a state of minimal responsiveness (vigilance score >7 WVS) on admission. We evaluate the course of rehabilitaiton and the outcome 6 months after the end of the inpatient-period. The average stay of 15·5 weeks is strikingly low. The average intensity of therapy comes to about 16 units per week including strategies of rehabilitative education. The incidence of good rehabilitation was 21%, whereas almost 45% of patients displayed severe impairment. Although further improvements were found in almost 40% of patients 6 months later, these only slightly changed the overall picture of the GOS values. More than 3/4 returned to their families after rehabilitation, often despite great functional impairment. A return to the former environment outside the family (kindergarten, school) was, however, possible in 2/3 of the subjects. The proportion of minimally responsive patients fell from 73·7% to 18·4% during the stationary rehabilitation phase. After a further 6 months (follow up), 36·4% of the originally minimally responsive patients achieved a GOS value of >5.     

外伤后急性脑肿胀术中急性脑膨出的防治

目的 为探讨外伤后急性脑肿胀术中急性脑膨出的原因及防治措施，以提高该类病人的疗效。方法 对我科手术的82例急性脑肿胀病人的临床资料进行回顾性分析。结果 术中急性脑膨出发生率为37．8％(31／82)，其中急性半球性脑肿胀急性脑膨出的发生率为33．3％(18／54)，急性全大脑肿胀急性脑膨出的发生率46．4％(13／28)。31例急性脑膨出患中，19例低氧血症，7例低血压，14例发生了迟发性血肿。术后半年随访疗效按COS标准：治愈8例，重残4例，中残2例，植物生存1例，死亡16例。结论 预防术中急性脑膨出的重点是早期手术、及时纠正低氧血症和低血压以及呼吸机的合理使用。处理的关键是采用标准脑外伤开颅术、控制性降低血压、应用巴比妥类药物和及时清除迟发性血肿。     

Neurological involvement in hemolytic-uremic syndrome

Of 44 children with hemolytic-uremic syndrome seen at Milwaukee Children's Hospital, 15 (34%) had neurological involvement. This group contained 8 boys and 7 girls, with a mean age of 3 1/4 years. Twelve patients had seizure within 48 hours of admission. Seizures were associated with hypertension, fever, hyponatremia, or hypocalcemia. Other neurological symptoms included altered consciousness, behavioral changes, diplopia, and dizziness. Hemiparesis (4 patients), eye involvement (7 patients), decerebrate posturing (2 patients), and ataxia (1 patient) were present on physical examination. Cerebrospinal fluid examination showed increased protein in 4 of 11 patients. Electroencephalograms were abnormal in all 9 patients tested. Computed tomographic and radionuclide scans showed evidence of vascular abnormalities in 4 of the 14 patients studied. Complete neurological recovery occurred in only 6 of the 15 children, while the remaining 6 demonstrated residual hemiparesis, seizures, and cortical visual defect. In those children with neurological involvement, there was a higher incidence of residual hypertension (49% versus 11%), chronic renal damage (40% versus 3.5%), and death (28% versus 0%), suggesting that central nervous system involvement indicates severe hemolytic-uremic syndrome.     

Obsessive-compulsive symptoms during treatment with olanzapine and risperidone: a prospective study of 113 patients with recent-onset schizophrenia or related disorders

OBJECTIVE: To determine whether severity of obsessive-compulsive symptoms (OCS) differs during treatment with olanzapine or risperidone and to establish whether duration of antipsychotic treatment is related to severity of OCS. METHOD: We conducted a prospective study of consecutively hospitalized young patients (mean age = 22.4 years) with DSM-IV schizophrenia or related disorders (N = 113) who were treated with olanzapine or risperidone. Olanzapine or risperidone was randomly prescribed for patients who were drug-naive or were treated with typical antipsychotics before admission (N = 36). Patients who had started olanzapine (N = 39) or risperidone treatment (N = 23) prior to admission continued with that medication if they showed initial clinical response. Patients who prior to admission started olanzapine (N = 6) or risperidone (N = 9) but showed no response or suffered from adverse effects switched at admission to risperidone or olanzapine, respectively. Medical records, parents, and patients revealed information on duration of treatment and compliance with olanzapine or risperidone prior to admission. The Yale-Brown Obsessive Compulsive Scale (YBOCS) was administered at admission and 6 weeks thereafter. RESULTS: At baseline and 6-week assessments, OCS were found in about 30% of 106 evaluable cases and 15% met DSM-IV criteria for obsessive-compulsive disorder. No differences in OCS were found in the patients randomly assigned to olanzapine or risperidone. The 35 subjects treated with olanzapine at both assessments had significantly (p = .01) more severe OCS at week 6 than the 20 subjects treated with risperidone at both assessments. Duration of treatment with olanzapine was significantly (p < .01) related to severity of OCS. CONCLUSION: There are no differences in the short-term propensity of olanzapine or risperidone to induce or exacerbate OCS. However, severity of OCS was associated with duration of treatment with olanzapine.     

早期脑血流量检测在预测蛛网膜下腔出血迟发性脑缺血患者预后的作用研究

目的探讨早期脑血流量检测对蛛网膜下腔出血(SAH)迟发性脑缺血(DCI)患者预后的预测作用。方法选择2008年1月～2012年11月来我院接受治疗的SAH后DCI患者150例。根据5年后患者临床结局分为存活组(n=96)和死亡组(n=54)。比较两组患者在临床特征方面的差异。绘制ROC曲线,计算曲线下面积评估各参数的预测效力。应用单因素、多因素非条件Cox回归分析预测SAH后DCI患者预后的危险因素。采用Kaplan-Meier法绘制累积生存曲线,采用Log-Rank法比较生存率差异。结果 150例患者术后5年96例(64%)存活,54例(36%)死亡。单因素、多因素Cox回归分析结果显示,脑血流量(CBF)15.82ml/100g/min、PAASH分级≥4级、Fisher分级≥III级不利于患者预后(P0.05)。随访5年后,CBF15.82 ml/100 g/min的患者累积生存率为18%(9/50),显著低于CBF≥15.82 ml/100 g/min患者的累积生存率45%(45/100)(P0.05)。结论入院时CBF可作为预测SAH后DCI患者预后的重要指标。     

重型颅脑损伤患者精神障碍的临床分析

目的 探讨重型颅脑损伤后精神障碍的发生率、表现形式及影响因素。方法 以深圳市1999年10月1日至2000年9月30日因交通事故所致重型颅脑损伤的183例幸存者为研究对象,在颅脑损伤治疗后（平均6个月）,由2名精神科副主任医师根据中国精神疾病分类方案与诊断标准第2版修订本对这些伤者的精神状态进行评估。结果 （1）在183例中,罹患各类精神障碍者共165例,发生率为90．2％,其中智能障碍者为142例（77．6％）。（2）在183例,中度及其以上智力损伤者为29例（15．8％）。（3）有智力损伤组的脑干损伤、颅内血肿及≥3个脑叶损伤的比例高于无智力损伤组（P＜0．01）;伴有精神障碍组的平均年龄（P＜0．05）、脑干损伤（P＜0．05）及≥3个脑中损伤（P＜0．01）的比例高于无精神病性障碍组;有人格改变组额叶损伤、开颅清除血肿并减压治疗的比例高于无人格改变组（P＜0．01）。结论 重型颅脑损伤后精神障碍的发生率较高,应引起有关临床学科的重视。     

Metabolic response in the acute stage of cerebral infarction--with special reference to oxygen consumption and resting metabolic expenditure

Oxygen consumption, carbon dioxide production, respiratory quotients, and resting metabolic expenditure were measured in 23 patients with cerebral infarction in their acute stage. Metabolic measurement were carried out with the technique of indirect calorimetry on their admission within two days from the onsets. At the same time, urine was collected twenty-four hours to measure urinary catecholamine excretion. Mean value of resting metabolic expenditure was 115.1% and this positively correlated with urinary catecholamine, especially noradrenaline excretion. Maximum value of resting metabolic expenditure was up to 187.1% of that expected for an uninjured resting person of equivalent age, sex, and body surface area. Oxygen consumption and carbon dioxide production also positively correlated to urinary catecholamine excretion. On the other hand, respiratory quotients did not have any significant correlation with oxygen consumption, carbon dioxide production, resting metabolic expenditure, or urinary catecholamine excretion. From those facts, it was implied that overactivity of sympathetic nervous system existed in their acute stage of cerebral infarction, and the overflow might directly influence oxygen consumption, carbon dioxide production, and resting metabolic expenditure, and moreover we had to take into consideration of hyper-metabolic state to manage patients with ischemic cerebrovascular diseases as malnutrition might cause weight loss and immune incompetence.     

Prognostic factors in artificially ventilated stroke patients

OBJECTIVES: To evaluate the reasons for implementing artificial ventilation (AV) in patients with acute ischemic stroke (AIS), determine their outcome and characterize prognostic variables in these patients. METHODS: Consecutive patients presenting with AIS were evaluated. All patients who received AV were treated in a neurological semi-intensive care setting. RESULTS: Of the 173 patients included in the study, 27 (16%) needed AV, 16 (9%) received AV and five of these patients (31%) survived. The mean NIH stroke scale score prior to AV was 14.5+/-5.6 (vs. 9.1+/-6.2 in non-intubated patients, P=0.001). Six patients were ventilated because of neurological deterioration. Most of these patients had large hemispheric infarctions with evident herniation and midline shift on CT scans. The only one who survived the acute hospitalization did not recover and died within 3 months. In the other 10 patients, AV was instituted during cardiopulmonary decompensation (CPD). These patients generally fared better; four of them survived and were discharged after a lengthier hospital stay when compared to non-intubated patients. Variables associated with survival among intubated patients were a lower neurological disability score on admission and on day 7 after the stroke, and intubation during CPD. CONCLUSIONS: Implementing AV in semi-intensive care settings does not seem to improve survival in AIS patients with neurological deterioration. Stroke patients who need AV during CPD and those that have less severe neurological deficits may have better chances for survival.     

2008年-2018年广西省某精神专科医院入院人次季节变化及趋势预测

目的 分析广西省某精神专科医院精神障碍患者入院人次的季节性变化,预测2019年-2021年入院人次,为优化医院管理和资源配置提供参考。 方法 统计广西省某三级精神专科医院2008年-2018年各月份的入院人次,利用季节指数法对11年间各月（季度）进行动态分析,并用灰色模型预测2019年-2021年入院人次。 结果 该院2月、3月、4月、5月、10月、12月精神障碍患者入院人次季节指数均大于100%,分别为100.53%、115.86%、106.76%、102.58%、100.93%、100.43%。通过灰色预测模型建模,预测2019年-2021年入院量分别为6 878、7 476、8 125人次。 结论 2012年-2021年该医院精神障碍患者年入院人次呈逐年递增趋势,上半年尤其是春季为入院高峰期。