学龄前儿童意外伤害流行病学特征和防范研究

目的探讨学龄前儿童意外伤害流行病学特征和儿童创伤的防范措施。方法收集我院自2010年1～12月收治的2 198例学龄前儿童意外伤害病例资料,回顾分析其致伤原因及临床流行病学特征,探讨其伤情特点和防范措施。结果 2 198例受伤学龄前患儿中,最易发生伤害年龄在1～3岁年龄组(53.28%),明显高于其他年龄组(P<0.05);坠落、跌倒及交通事故所致创伤是儿童意外伤害的主要类型;主要在家中(42.32%)和幼儿园(35.17%)发生;暑期发生率高于其它月份(P<0.05)。结论学龄前儿童意外伤害有其自身的流行病学特征,加强看护和安全教育,政府立法和全社会共同参与,是预防儿童创伤发生的重要措施。     

意外伤害住院患儿流行病学调查

目的探讨儿童意外伤害的发生规律,为儿童意外伤害的预防和干预提供理论依据。方法收集1997年10月—2005年6月因意外伤害住院的2782例患儿的相关临床资料,将伤害类型分为烧烫伤、跌伤、交通意外、炸伤、砸伤、锐器伤、中毒、其他(包括电击伤、溺水、动物咬伤、击打伤、气管异物等)8种,分组调查分析。结果意外伤害发生的年龄顺位为:学龄儿、学龄前儿童、青春期、婴幼儿;男性明显高于女性;农村为意外伤害高发区,家庭为伤害高发场所,意外伤害发生率以8%的速度逐年上升;居前三位的伤害为:跌伤、交通意外、烧烫伤;伤害谱较前10年有显著变化,并存在巨大的卫生资源损耗。结论意外伤害有显著的流行病学特征。应针对性地制定相应的干预措施。     

意外损伤住院儿童损伤类型与原因分析

目的：了解儿童意外损伤的发生情况，为儿童意外损伤的预防提供依据。方法：对收住院的2960例意外损伤儿童的病案首页进行统计，分析不同年龄，性别和地区的损伤类型及原因构成。结果：2960例意外损伤住院儿童中，骨折991例（占33．5％），烧伤，烫伤609例（占20．6％），内脏及颅内损伤536例（占18．1％），开放性损伤291例（占9．8），男女比例为2．2：1。各类意外损伤年龄特点：烧伤／烫伤多发生了3岁以下儿童（占51．2％，312／509），0－1岁儿童是发病高峰年龄段（占33．7％，205／609），骨折多发生了3岁以上儿童（占91．6％，908／991），而以6－14岁儿童为最多（占69．3％，687／991），交通伤多发年龄段为6－14岁（占66．7，478／717），跌落伤多发年龄段为6岁以上（占65．1％，576／885），年龄跨度最大。各类损伤住院总费用为3938583．4元，人均1330．6，总住院日为50778d，人均17.2d。结论：各类损伤的发生在不同年龄，性别和地区间有着明显特点，可根据具体情况采取相应的防范措施，减少其发病率是完全可能的。     

儿童意外伤害的原因与预防研究进展

儿童意外伤害是现代社会一个严重的健康问题,已成为我国儿童的第一“杀手”。意外伤害不仅可以导致儿童死亡、残废及发育障碍,而且严重影响了儿童的身心健康、正常生活和学习。本文对交通事故、溺水和窒息、烧伤与烫伤、中毒、跌落伤、危险因素等方面进行了原因分析和预防措施的综述,对降低儿童意外伤害的发生,提高儿童的生存质量有积极的指导作用。     

2005～2010年396名军人伤害住院病情分析

目的:对某区部队伤害住院患者进行流行病学特征分析,提出预防建议。方法:应用我院的病历数据库资料进行分析。结果:意外损伤、军事训练伤、运动伤是导致部队伤害住院的3大主要因素。伤害主要发生在18～24岁(占76.77%)之间,干部意外损伤、运动伤、斗殴伤和交通伤高于战士,军事训练伤则战士明显高于干部。结论:部队要重视和加强伤害的预防工作。     

2 294名军人伤害住院情况分析

目的：对某区部队伤害住院患者进行流行病学特征分析，提出预防建议。方法：应用各医院上报军区统计中心的数据库资料进行分析。结果：意外损伤、军事训练伤、交通伤和烧烫伤是导致部队伤害住院的四大主要因素。伤害主要发生在18—23岁(占62．16％)之间，干部意外损伤、交通伤和锐器伤高于战士，军训伤则战士明显高于干部。结论：部队要重视和加强伤害的预防工作。     

进一步加强创伤和意外伤害防控的宣传教育

创伤和意外伤害主要是指由于道路交通伤、烧伤、各种工矿事故以及中毒等所造成的人员损伤和死亡.据相关资料统计,目前创伤和意外伤害造成的损伤和死亡在我国疾病死亡谱中已跃居第4位,在45岁以下青壮年中则高居榜首.创伤和意外伤害已经成为威胁我国人民生命健康、降低生活和工作质量、显著减少劳动力以及影响社会和谐与稳定的重要因素之一.因此,加强创伤和意外伤害的防控,既是国家发展的重大战略需求,也是应对疾病谱变化的重要措施之一,应当引起全社会的高度重视并积极采取措施加以应对.     

高速公路儿童腹部交通伤的临床特点及救治

道路交通伤害日益成为危害健康的一个全球公共卫生问题.据WHO统计,在5～29岁的青少年及儿童中,道路交通伤害是全球的第二大死因[1].而儿童体型小、认知能力不完全、防护能力差的特点导致高速公路交通伤已成为其意外伤害的主要原因,其中以腹腔内实质性脏器损伤为多见[2,3].     

高速公路儿童腹部交通伤的临床特点及救治

道路交通伤害日益成为危害健康的一个全球公共卫生问题.据WHO统计,在5～29岁的青少年及儿童中,道路交通伤害是全球的第二大死因[1].而儿童体型小、认知能力不完全、防护能力差的特点导致高速公路交通伤已成为其意外伤害的主要原因,其中以腹腔内实质性脏器损伤为多见[2,3].     

高速公路儿童腹部交通伤的临床特点及救治

道路交通伤害日益成为危害健康的一个全球公共卫生问题.据WHO统计,在5～29岁的青少年及儿童中,道路交通伤害是全球的第二大死因[1].而儿童体型小、认知能力不完全、防护能力差的特点导致高速公路交通伤已成为其意外伤害的主要原因,其中以腹腔内实质性脏器损伤为多见[2,3].     

Hospitalisation due to sports-related injuries among children and adolescents in New South Wales, Australia: An analysis on socioeconomic and geographic differences

This population-based epidemiological study aims to investigate the associations between socioeconomic status, geographic location, and sports-related injuries among children and adolescents in New South Wales (NSW), Australia. Data utilised in this study were collected as part of the routine vital health information system via all hospitals in NSW. Included were all patients aged between 5-19 years admitted to a hospital because of sports-related injuries in NSW between 1996 and 2000. The crude age-and-sex-specific hospitalisation rates (/100,000 population-years) by socioeconomic levels and geographic residential locations were calculated. Negative Binomial regression analyses were also performed to examine the associations between socioeconomic status, geographic location and the rate of hospitalisation after adjusting for the age and sex of children and adolescents. The results indicated a significant association between geographic location and hospitalisation due to sports-related injury, after adjusting for age, sex, and socioeconomic status. The risk of hospital admission with sports-related injury among children and adolescents in rural areas was nearly 10% higher than for those in the metropolitan areas (RR=1. 12, 95%C.I.=1.07-1.32)). However, no association between socioeconomic status and hospitalisation with sports-related injury was found. Greater efforts are required in the implementation of safety strategies in research, training, and education for the prevention of sports-related injury in rural areas.     

Non-fatal sports and recreational violent injuries among children and teenagers, United States, 2001–2003

BACKGROUND: An estimated 2.7 million non-fatal unintentional sports and recreational injuries are treated in U.S. hospital emergency departments (EDs) annually. However, little is known about the number of sports and recreational injuries resulting from violent behavior. METHODS: Data for 2001-2003 on sports and recreational injuries were obtained from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP)-a national sample of 66 U.S. EDs. National estimates and rates of persons treated for violence-related sports and recreational injuries in EDs are compared to those treated for unintentional sports and recreational injuries. Types of injuries and injury circumstances are described. RESULTS: During the study period, an estimated 6,705 (8.3 per 100,000; 95% confidence intervals (CI), 6.3-10.3) children and teenagers with violence-related sports and recreational injuries were treated in U.S. EDs annually, compared to 2,698,634 children and teenagers with unintentional sports and recreational injuries. Thus, violent behavior accounted for 0.25% of sports and recreational injuries. The highest incidence rate (13.6 per 100,000) for violence-related sports and recreational injuries was for children aged 10-14 years. Most patients with violence-related sports and recreational injuries were treated and released from the ED. A majority of those with violence-related sports and recreational injuries were injured to the head/neck region (52.2%), of which 24.1% were treated for traumatic brain injuries. Most violent injuries resulted from being pushed or hit (65.6%); the most common sports and recreational activity varied by age: playground (65.2%) for children < or =9 years; bicycling (26.7%) for 10-14-year-olds; basketball (45.3%) for 15-19-year-olds. CONCLUSIONS: National ED surveillance systems can provide useful information pertaining to prevention programs designed to reduce sports and recreational injuries resulting from violent behavior and unintentional causes.     

重庆城乡0～19岁人群交通伤害特点与危险因素比较分析

目的 比较重庆地区城乡之间0～19岁人群交通伤害特点及危险因素,并探讨防治策略。方法 从道路交通事故与交通伤数据库中调取重庆市城区、城乡结合部和郊县各1个行政区2000 - 2006年交警登记的0～19岁人群交通伤害数据资料,分析青少年交通伤害流行病学特征,比较造成城乡青少年交通事故与交通伤的特点与差异。结果 2000 - 2006年,城乡结合部青少年交通伤发生率和死亡率最高,分别为95.43/10万、3.44/10万;郊县的交通伤害发生率最低,但是危害程度却最高,伤亡人数中死亡和重伤比例分别达9.06％、17.33％。头部损伤是最主要的致死原因。伤亡青少年中62.70％为行人,承担同等责任以上的青少年占20.72％,主要为不遵守交通信号、突然横穿公路和不走人行道。不论城乡,90％以上的交通事故发生于缺少交通信号／交警管制的路段。结论 青少年交通事故形势严峻,应加强对青少年的交通安全意识和行为教育,加强城乡结合部和郊县青少年交通伤的预防,加强郊县交通伤急救系统的建设,为青少年提供安全的道路交通环境。     

Fatal unintentional injuries among young children – A hospital based retrospective analysis

Unintentional (accidental) injuries in childhood constitute a significant public health problem. Young children are extremely vulnerable to unintentional injuries that are vastly preventable. All cases of fatal unintentional injuries in children aged 10 years and below autopsied during 1994–2007 were retrospectively reviewed. Seventy five such cases were identified during the 14 year study period. Males accounted for 68% of cases with a male–female ratio of 2.1:1. Mean age of male and female victims was 5.3 and 4.9 years, respectively. Road traffic fatalities accounted for majority of the cases in this age group (52%), followed by those due to thermal injuries (22.7%). Flame was the cause of thermal injuries in 52.9% cases and scalds were observed in 47.1% cases. Traffic fatalities, fall and drowning were more common in school age children while toddlers and pre-school age children were relatively at a greater risk from domestic accidents (thermal injuries and poisoning). The most frequent victims of road traffic incidents were pedestrians (64.1%). Head injuries alone were the cause of fatalities in the majority of road traffic incidents (82.1%). The study highlights on the pattern of fatalities due to unintentional injuries among young children. To reduce the burden of unintentional childhood mortalities in this region, priorities for school age children are traffic injuries and for toddlers and pre-school children, thermal injuries.     

Pediatric and adolescent injury in skiing

ABSTRACT

This review examines risks that accompany child and adolescent participation in downhill skiing. Falls and non-collision events were the most common mechanism of injury, but significant data implicate head injuries, blunt abdominal trauma, and spinal trauma as the leading causes of morbidity and mortality in this population. School-aged children and youth (7–14 years) are more likely to sustain an injury, compared to children (0–6 years) and older teenagers (15–17 years). Knee injuries were the most common injury, reported as 10.3%-47.7% of all lower limb injuries. The literature supports helmet use as protective against injury with a reduced risk of head, neck, or face injury in children under 13 years. Future studies are necessary to evaluate injury and risks in the backcountry given the rapid increase of adolescents traveling outside ski areas. Research examining risk factors and preventive measures in youth skiing is also warranted.     

Spinal injuries in skiers and snowboarders

Spinal injuries are among the most devastating injuries associated with recreational sports. Snowboarding spinal injury patterns have not been described. During two seasons (1994 to 1995 and 1995 to 1996), 34 skiers and 22 snowboarders suffered serious spinal injuries (fracture or neurologic deficit or both) at two ski areas in British Columbia, Canada. Ski patrol records, the Provincial Trauma Database, and hospital records were reviewed. Injury rates were based on computerized lift-ticket data and a population estimate of 15% snowboarders (ski patrol observation). The incidence of spinal injury among skiers was 0.01 per 1000 skier-days, and among snowboarders was 0.04 per 1000 snowboarder-days. Mean age was 34.5 years for skiers and 22.4 years for snowboarders. Seventy percent of the skiers were men, whereas all of the snowboarders were men. Jumping (intentional jump > 2 meters) was the cause of injury in 20% of skiers and 77% of snowboarders. Neither age nor sex accounted for any significant portion of this difference. The rate of spinal injuries among snowboarders is fourfold that among skiers. Although jumping is the primary cause of injury, it is an intrinsic element of snowboarding. Until research defines effective injury-prevention strategies, knowledge of the risk of snowboarding should be disseminated and techniques for safe jumping should be taught.     

826例汶川地震住院伤员伤情特点及救治分析

目的 分析汶川地震住院伤员的伤情特点及救治,为类似自然灾害所致伤员的救治提供参考.方法 利用<创伤数据库系统>V3.0收集录入的四川大学华西医院和德阳市第一和第二人民医院收治的地震伤员资料,对伤员一般情况、伤情特点和治疗措施进行分析比较.结果 共收集资料较为完整、符合要求的伤员826例,其中男410例,女416例;年龄1～102岁,平均45.8岁.其中31～60岁伤员占总数的50.2%.有职业记录的477例中,农民占43.8%(209/477),工人占15.7%(75/477),在校学生占14.1%(67/477).钝器伤(53.2%)、挤压/掩埋(22.5%)和跌倒/坠落(15.0%)为前3位致伤原因.德阳市两家医院收治的伤员入院时间主要集中在地震后4 d内,占92.1%;华西医院收治的伤员入院时间主要集中在震后3～9 d(81.7%).骨科伤员占伤员总数的59.2%.伤员的AIS主要集中在1～3分的区域.严重多发伤(ISS>16分)发生率为8.2%.入院后接受内固定术120例(34.1%),清创缝合术103例(29.3%)及外固定术55例(15.6%).肢体离断术22例(6.3%),颅内手术仅2例(0.6%).结论 地震导致的建筑物倒塌是主要致伤机制,伤员以骨伤较多.损伤多在AIS 1～3分范围,严重多发伤较少.伤员接受专业救治时间普遍较晚,伤员后送分流较迟,提示对特大自然灾害所致伤员的早期救治和及时高效后送救治的能力亟待加强.     

Hand injuries in volleyball.

We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66% of all injuries. The mean age was 26 years, with a peak in the age group of 15 to 29 years. Sprains and strains were observed most frequently (39%), followed by fractures (25%) and contusions (16%). The fingers were involved in 44% of the cases. Most injuries of the hand occurred in recreational players. Recreational players had more left-sided injuries, whereas competition players had more right-sided injuries (P less than 0.005), suggesting that lack of skill is an important determinant. Left-handedness was associated with an increased risk of hand injury in recreational players. One third of the volleyball players did not go to work or school for a median of 4 weeks as a result of the injury. In a survey after a mean period of 5 years, a high percentage of patients had complaints: 28% cited stiff and crooked fingers with limitations and tenderness in the movements as main inconveniences. We consider this incidence disturbingly high, regarding the seemingly innocent nature of these injuries.     

深圳市1328例道路交通伤流行病学特征及伤情特点分析

目的 通过医院急诊就诊渠道分析深圳市道路交通伤的流行病学特征及伤情特点.方法 预先设计调查问卷,在2007年1月-2007年12月对深圳市6所综合性医院急诊外科收治的道路交通伤患者的临床资料进行分析. 结果 共收集道路交通伤患者1 328例;年龄2～84岁,平均31岁.受伤人群主要为工人和农民工(57.8%);肇事车辆主要为小型汽车(48.5%);道路交通伤发生主要地点为市内公路(78.6%);伤害发生的周分布中,以星期五、六最多,分别达到17.8%和18.7%,在星期五存在集中趋势(r=0.166 0,P<0.01).伤害发生的昼夜分布中,围绕下午15:35存在集中趋势(r=0.285 6,P<0.01);男性年龄(32.36±8.70)岁,大于女性年龄(29.96±4.32)岁,差异有统计学意义(P<0.01).随访患者中84.4%恢复原来工作,8.5%调换工作,7.1%不能参加工作. 结论 可以通过进一步加强工人和农民工交通安全教育,提高交通安全意识.根据道路交通伤的高发时间曲线在道路交通多发时段、地段适当增加交通管理人员,增加交通安全提示标志.控制小型汽车数量是减少交通事故发生的有效手段.