上海市2003～2007年道路交通伤院前急救流行病学调查

目的 探讨上海市2003～2007年道路交通伤院前急救流行病学特征.方法 以上海市急救中心同期的院前急救病例数据库和全市人口数据为基础,对其中的道路交通伤相关资料进行回顾分析.结果 五年中上海市中心城区共实施院前急救585 298人次,其中道路交通伤38 472例,由2003年的4.51%逐年增加至2007年的8.32%,其中男性所占比例呈逐年上升趋势.道路交通伤者以中年人为主,青年人受伤率逐年下降,而老年人受伤率逐年增加.道路交通伤院前急救的高峰时点和高峰时段分别为每日14:27～15:07和7:49～21:49.结论 上海市道路交通伤院前急救有其自身的流行病学特点,加强高危人群交通安全教育,合理配置院前急救资源,逐步建立一个较为完善的全市道路交通伤监测网络,都有助于减少道路交通伤的发生.     

德阳市儿童道路交通伤流行病学特点和预防措施

目的：探讨德阳市儿童道路交通伤流行病学特征,提高患儿道路交通伤救治水平和防范措施。方法：回顾分析德阳市人民医院自2010-01-2011-12收治的2498例儿童道路交通伤致伤原因及临床特点。结果：2498例儿童道路交通伤最易发生年龄段在〉4-9岁（54.28%）,明显高于其他年龄段（P〈0.05）。儿童道路交通伤以轻伤为主,擦挫伤为主要类型。汽车和摩托车是最主要肇事车辆和导致死亡的肇事车辆,主要的致死原因为颅脑损伤和腹部损伤。道路交通伤害主要发生在市区,发生时间主要在交通拥堵的上、下班时段。结论：德阳市儿童道路交通伤害有其自身的流行病学特点,倡导文明驾驶,完善道路交通公共设施建设,开展针对儿童道路交通事故防范的宣传教育,改进急救体系和服务模式等社会多方面的共同协作,将能有效的减少儿童道路交通伤害的发生。     

2079例交通伤患者的流行病学分析

目的:探讨急诊交通伤的流行病学特点。方法:选择2000年1月-2008年12月急诊抢救的交通伤患者2079例,按年龄、季节、外伤类型、外伤死亡原因、病死率等分类进行回顾性分析。结果:①年龄分布:年龄≤14岁,占1.3%;14～39岁939例,占45.2%;40～59岁865例,占41.6%;60～79岁176例,占8.5%;≥80岁71例,占3.4%。②按季度统计:1季度383例,占18.4%;2季度555例,占26.7%;3季度619例,占29.8%;4季度522例,占25.1%。以3季度交通伤发生病例数最多。③9年来交通伤病例数占各种外伤病例的65.2%,比例有逐年增高的趋势。④交通伤中损害部位最多的为颅脑和各种骨折,分别占总数的56.2%和15.7%;颅脑外伤和多发伤为交通伤常见的死亡原因,分别占总数的56.4%和33.7%。结论:通过对交通伤的流行病学分析,制定科学的防范措施,改进急救体系和服务模式,加强急诊创伤急救专业人员的培训,可以提高抢救成功率。     

道路交通伤

交通伤（ｔｒａｆｉｃｔｒａｕｍａ）是交通运输过程中造成的人身伤亡。广义的交通伤包括道路、铁路、航空和水上交通运输事故导致的人身伤亡。狭义的交通伤特指车辆在道路运输过程中发生的人身伤亡，称为道路交通伤（ｒｏａｄｔｒａｆｉｃｔｒａｕｍａ，ＲＴＴ）其最多见...     

长阳土家族自治县交通事故伤流行病学特点分析

目的总结和分析我县2002～2007年交通事故伤的流行特点。探讨我县目前对交通事故及事故伤的防治中存在的问题。方法收集2002～2007年全县发生的交通事故及事故伤，对其进行描述性研究。结果2002～2007年，共发生交通事故16853起，伤亡7995人中，男6483人，女1512人，男女之比为4．29：1。21～50岁年龄段伤亡比例最高，一年中7～11月是事故高发期（70．52％），乡镇属事故高发区（占74．16％）。引起交通事故伤的原因中人为因素占91．47％。结论近年来我县车辆数量急剧增加，交通事故及其致伤亡人数呈不断上升趋势，加强对道路交通的综合管理、有效缓解人车路的矛盾和提高驾驶人员素质与技能是降低交通事故及事故伤的有效措施。     

交通伤院前死亡的发生特点及护理对策

目的系统分析交通伤院前死亡的发生特点及其规律。探讨交通伤院前急救的护理对策。方法回顾性分析2001年至2004年交通伤院前救治4760例的临床资料。结果交通伤死亡810例中，院前死亡752例。占92．84％（其中现场死亡413例，占54．92％；运送途中死亡92例，占12．23％；急诊室死亡247例，占32．85％）；死亡的直接原因为重型颅脑损伤481例（63．96％）、严重多发伤113例（15．03％）。结论交通伤死亡病例主要发生在院前阶段，而现场死亡的比例最大，主要致死原因为重型颅脑损伤。可见，注重人员培训和现场救护技术，迅速到达现场，加强对重型颅脑损伤的早期救护，是降低交通伤死亡率的关键和重点。     

德阳市道路交通伤的流行病学分析

目的:分析德阳市导致受害者死亡的道路交通伤害流行特征.方法:回顾性收集德阳市2003～2005年度导致受害者死亡的道路交通伤害发生资料,分析死亡患者的年龄、性别、职业分布、道路使用情况及事故原因.结果:(1)男性死亡494人,占总死亡率的76.03%,女性死亡147人,占总死亡率的23.97%,死亡人员平均年龄为45.67±20.56岁.(2)排在前五位的死亡人员类型依次为:农民工,农林牧渔业,个体,不在业人员和工人,排在前三位的死亡人员交通方式依次为:步行,摩托车,自行车.(3)排在前三位的事故原因为机动车驾驶员、机动车以及非机动车驾驶员.结论:通过加强立法执法,开展宣传教育可预防和控制道路交通伤害的发生,提高急救水平能能减少伤害患者的死亡率.     

北京市1646例突发事件患者的特点分析及现场分流处理

目的从突发事件中找出特点和趋势,从现场分流和处理的角度为提高应急反应能力和医疗救援水平提供依据。方法对北京急救中心2000-2005年参与救援的突发事件进行回顾性调查,将其中发生成批伤病(3人以上伤亡的事件即定为成批伤病)的1646份急救病历,进行统计分析。结果北京市发生成批伤病呈逐年上升趋势,伤亡人数也由2000年的641人增加到2005年的1201人。外伤事件有增加的趋势,CO中毒呈下降的趋势,6年中所有事件类型中,交通伤所占的比例最多。虽然伤亡人数逐年增加,但死亡所占比例却呈下降趋势(X~2=128．67,P＜0．01)。伤亡人中男性所占比例有上升趋势(X~2=30．11,P＜0．01)。伤亡人中18～40岁者占73．3%。在不同季节中,除冬季为CO中毒高发季节外,春夏秋三个季节中均为交通伤所占比例最高。平均反应时间(从呼叫受理至急救车到达事发现场的时间)由2000年的15．6 min缩短到2005年的12．2 min。结论北京市突发事件最显著的特点是逐年增多,平均反应时间的逐渐缩短,虽然受伤人数明显增加,但死亡人数却没有明显增加,导致死亡所占比例呈下降趋势。     

河北省丰润区道路交通伤调查与分析

目的:通过2007年12月—2008年12月道路交通伤的调查分析,找出交通伤的特点,以降低其伤残率和死亡率。方法:通过我院"120"1年间接诊的2507车次、到医院救治的2934例伤员、死亡53例的临床资料进行分析,对道路交通伤事故发生的时间、地点、路段进行调查,分析交通事故发生特点、伤员伤情特点、道路及车辆对交通事故伤的影响因素。结果:道路交通伤伤情重、多发复合伤多,伤残率、死亡率高。结论:道路交通伤院前抢救十分重要,在提高急救人员急救技术的同时还要加强驾驶员及相关人员的急救知识普及;到医院后应快速纠正休克,补充血容量,尽早分清危及生命的伤情主次,采取有效治疗措施,降低伤残率、死亡率。     

中小城市交通伤院前急救特点分析

采用回顾性调查方法,统计分析资料,了解交通伤院前急救的高危人群、高发时间,为交通伤的预防提供依据.结果2008年1～12月我院急救中心院前急救的外伤病例中交通伤居首位,共1 224例,占总数的39.13%.在这一年内,以5～11月为高发期;在一天中,人们上下班时间是交通事故高峰.以21～40岁年龄组为高危人群,在交通事故中受伤及死亡的男性比率高于女性.提示预防和控制交通伤的主要措施是加强群众的交通安全意识,提高司机的安全行车意识和完善道路交通设施,确保良好的交通环境.     

北京市中学生道路交通伤害的流行病学调查

目的 了解北京市中学生道路交通伤害的特点,为预防和控制青少年道路交通伤害提供参考依据.方法 采用典型的方法,分别确定具有城区、近郊区和远县特征的区县各1个.然后确定每个区县的2所初中和2所高中作为被调查学校.最后,采用整群抽样的方法,对每个被调查初中学校的初一、初二年级和高中学校的高一、高二年级各两个班的所有学生进行调查.结果 北京市中学生过去1年内发生道路交通事故的比例达14.0%,其中男生交通事故发生率为16.5%,女生为11.5%,男女生发病率差异有统计学意义(x2=59.808,P＜0.01),初中学生高于高中学生.交通事故发生率有明显的中心城区倾向(x2=158.282,P＜0.01).各种交通方式中以骑自行车发生交通事故的比例最高,为1913%.2004年中学生因道路交通伤害受伤的比例为37.0%,男女生之间、各种交通方式之间差异无统计学意义,但年级越高、距离中心城区越远发生道路交通伤害的比例越大.结论 道路交通事故和道路交通伤害已经成为影响北京市中学生健康和安全的重要问题,必须采取积极的措施,预防和降低青少年道路交通事故和交通伤害的发生.     

AB or ABC: pre-hospital fluid management in major trauma.

Pre-hospital trauma care in the United Kingdom is a neglected field with little consideration being given to this phase. Of the 14,500 annual fatalities from road traffic accidents in this country, 60% die before reaching hospital and it has been estimated that one-third of these fatalities are due to hypovolaemia. The pre-hospital fluid resuscitation of trauma patients is a controversial area and although it would seem sensible to commence intravenous (i.v.) fluids at the roadside, several large studies have failed to show any benefit from this intervention. By delaying departure to hospital, initiation of i.v. fluid replacement may actually worsen outcome. This paper reviews recent studies and discusses current thought on pre-hospital fluid replacement in major trauma.     

Frequency of road accidents in prishtina in the period 2007–2010

ObjectiveTo assess the predictors of fatal road traffic accidents following the war during the year 1999.MethodsThe period January 2007-December 2010 has been considered for this research. The used criterion for this research was the distribution of vehicle accidents on a yearly basis, injuries based on systems, vehicle drivers based on their sex, age, causes, accident location, road type, accident type and presence of driving permit.ResultsThe injured in traffic accidents who have sought emergency medical assistance in the Emergency Center from January 2008 until December 2010. In the period January to December 2007 was 44 111, from which 2 235 or 5.06% were the injured in the road traffic accidents. In the period January to December 2008 the total number of sick, injured and poisoned persons who have sought emergency medical assistance in the Emergency Center was 43 610, with a total number of 2 148 or 5.00% injured in the road traffic accidents. In the period January to December 2009 the total number of sick, injured and poisoned persons who have sought emergency medical assistance in the Emergency Center was 44 228, and the total number of injured in the road traffic accidents was 2 774, or 6.27%. In the period January to December 2010 the total number of sick, injured and poisoned who have sought emergency medical assistance in the Emergency Center was 41 614, and injured from road traffic accidents were 2 384, or 5.72%.ConclusionsYoung age, high speed, and alcohol are predictors of fatal road traffic accidents in Pristine district.     

A case of maternal pelvic trauma following a road traffic accident, associated with fetal intracranial haemorrhage.

Maternal pelvic injury resulting from road traffic accidents may cause fetal intracranial haemorrhage. A case is described. Caesarean section should be considered in acute trauma.     

Benzodiazepine-like hypnotics and the associated risk of road traffic accidents

The aim of the study was to investigate the association between the use of benzodiazepine or benzodiazepine-like hypnotics and the risk of road traffic accidents. Data from three French national databases were matched: the health-care insurance database, police reports, and the police database of injury-related traffic accidents. A total of 72,685 drivers involved in injury-related road traffic accidents in France, from 2005 to 2008, were included in the study. The risk of being responsible for a traffic accident was higher in users of benzodiazepine hypnotics (odds ratio (OR) = 1.39 (1.08-1.79)) and in the 155 drivers to whom a dosage of more than one pill of zolpidem a day had been dispensed during the 5 months before the collision (OR = 2.46 (1.70-3.56)). No association was found between the use of zopiclone and risk of traffic accidents. Although this study did not find any association between the use of zolpidem as recommended and causation of traffic accidents, the potential risk related to possible abuse of the drug and risky driving behaviors should be further investigated. The results related to benzodiazepine hypnotics are consistent with those of previous studies.     

嘉定区1402例交通事故伤院前急救调查分析

目的：对上海市嘉定区交通事故伤进行回顾性分析,探讨院前急救交通事故伤的特点,为提高院前急救对交通事故伤的处置能力提供科学依据。方法：采用回顾性分析的方法,随机抽取嘉定区医疗急救中心收治的1402例车祸病例进行回顾分析。结果：交通事故伤损伤部位排在前三位分别为颅脑损伤、四肢外伤和多系统损伤,分别占33.2%、32.3%和15.8%;发病年龄主要集中在16～60岁的人群中,占83.1%;交通事故伤急救应急平均反应时间为9分6秒;交通事故伤发生的时间梯度主要集中在白天,高锋在12∶00～15∶00之间;发生交通事故伤最多的六条公路依次为曹安公路、浏翔公路、沪宜公路、嘉行公路、宝安公路和澄浏公路。结论：加强交通法规和交通安全教育及交通安全的监管力度,同时提高院前急救对于交通事故伤的急救能力,利用防治结合的方法,将有利于降低交通事故伤亡发生率和交通事故的致残率和致死率。     

Analysis of structure of concomitant traumatic brain injury based on multi-field hospital data

The structure and the circumstances of injury were studied in patients with severe TBI. 110 cases were studied retrospectively. More than 70% of the patients were from 20 to 60 years old, most of them men (80,91%). The main cause of injury was road accident (59,09%). 56,36% of patients were taken to hospital within the first hour after the accident. The average score by Glasgow scale was 8 (6;12). Lowest scores were registered in patients after railroad accidents [7,5(5;10)], in pedestrians [8(5;12)] and passengers [9 (6;12)] after road accidents and in criminal trauma cases [9,5(8;11)]. The most severe injuries by PTS scale were registered in patients after railroad accidents [50(44;56)], in criminal trauma cases [39(36;41)] and in pedestrians [31(22;42)]. The injuries were often accompanied by subarachnoid hemorrhage (46,36%). The most often outcome among patients with intracerebral hematoma, intraventricular hemorrhage, chest and pelvis injury was death. Thus we carried out retrospective analysis and studied the structure and the circumstances of TBI in Rostov on Don.     

Characteristics of traumatic spinal cord injuries in south-eastern Anatolia, Turkey: a comparative approach to 10 years' experience

The purpose of this study was to determine the demographic and epidemiological characteristics of traumatic spinal cord-injured patients. The hospital records of 539 patients (416 men, 123 women) with spinal cord injuries (SCIs) admitted to four hospitals that were major referral centers for trauma in the south-eastern region of Turkey from 1990 to 1999 were reviewed retrospectively. The patients with SCI were investigated for two periods; the first period covered patients admitted between 1990 and 1994 during which time an influx of people from rural to urban areas occurred and firearm injuries were common. In the second period (1995-1999) the influx of people declined and firearm injuries were reduced. The most common causes of injuries were road traffic accidents (200, 37.12%), followed by falls (172, 31.90%) and bullet wounds (115, 21.34%). In the first period, incomplete paraplegia was encountered more often than in the second period (P<0.001). In conclusion, in our series, while the leading cause of SCI for the two time periods was road traffic accidents, firearm injuries for the first period and falls for the second period were second-most frequent causes of SCI. In addition, the present study suggests that demographic and epidemiological factors may affect the characteristics of SCI in a region-based population even in a 10-year period of time.     

Baby walker related injuries--a continuing problem.

Baby walkers have been associated with burns, head trauma and other types of injury. A retrospective study of all infants under the age of two years attending an accident and emergency unit demonstrated 22 injuries associated with baby walkers from a total of 1049 attendances. The most serious injuries were three skull fractures, with the most common mechanism being of a fall downstairs in the walker. Injury while in a baby walker occurred with a similar frequency to injury due to road traffic accidents. We conclude that despite previous warnings Baby Walkers still represent a considerable hazard to infants.