上海市2011-2015学年中小学生伤害的流行特征分析

目的 了解上海市中小学生伤害的流行病学分布特征，为制订儿童青少年伤害干预措施提供基础资料。方法 利用2011-2015学年"上海市学校因病缺课缺勤网络直报系统"中中小学生因新发伤害缺课的监测数据进行统计描述与分析。结果 上海市2011年9月~2016年6月中小学生共报告伤害事件26 061例，以男生（71.3%）为主，超九成伤害事件发生在6~10岁（41.8%）和11~15岁（48.8%）年龄组，小学一年级、初中预备班、高一年级伤害事件所占比例高于同学段其他年级，4、5月和9、10月为伤害事件多发月（54.7%）。骨折（48.1%）、脱拉/扭伤/拉伤（19.7%）和擦伤/挫伤（15.0%）是最常见的三种伤害性质，且以单一性质为主（97.1%）。各伤害性质在不同性别（χ2=193.474，P<0.001）、学段（χ2=1 349.245，P<0.001）、月份（χ2=290.992，P<0.001）的分布差异有统计学意义。男生发生骨折（49.8%vs.44.0%）、开放性伤/出血（9.6%vs.7.8%）的比例高于女生，女生发生脱拉/扭伤/拉伤（22.0%vs.18.7%）、擦伤/挫伤（16.1%vs.14.4%）的比例高于男生。随着年级的增长，骨折、擦伤/挫伤、开放性伤/出血、烧/烫伤、挤压伤占比逐渐下降；脱拉/扭伤/拉伤、肌肉肌腱劳损的构成比逐渐上升；创伤性脑损伤的构成比稳定在1.3%左右。结论 伤害的发生及其性质在不同性别、年级、月份具有不同的分布特征，应根据不同人群，在不同时间有针对性地开展健康教育并采取相应预防措施。     

Childhood deaths and injuries in Finland in 1971-1995

BACKGROUND: This study examined the recent nationwide trends for the absolute number and the age- and sex-specific incidence rates of the fatal and serious non-fatal injuries among 0-14 year old children in Finland in 1971-1995. METHODS: We selected from Official Cause-of-Death Statistics and National Hospital Discharge Register children aged 0-14 years who died or required treatment at a hospital department because of an injury in 1971-1995. The number of Finnish children was 1.1 million in 1971, and 1.0 million in 1995. RESULTS: During the entire study period injuries were the leading cause of death in children aged 1-14 years, but not in infants. However, in these years the incidence (per 100 000 people) of fatal injuries in Finnish children decreased considerably in all age groups and both sexes, in girls from 20.1 in 1971 to 4.6 in 1995, and in boys from 36.7 in 1971 to 9.3 in 1995. In 1995, 41% of all the injurious deaths among 0-14 year old Finnish children were motor vehicle accidents, 12% were drownings, and 24% intentional injuries. The overall number and incidence of serious non-fatal injuries among Finnish children showed no clear trend change in 1971-1995. The mean hospitalization time of injured children shortened between 1971 and 1995, from 7.4 days to 2.7 days. CONCLUSIONS: We conclude that the number and incidence of fatal childhood injuries have decreased dramatically in Finland between 1971 and 1995. The reasons for this positive development are multifactorial, but improved traffic safety and trauma care are probably very important. In children's serious non-fatal injuries the development has not been so encouraging and therefore children's injury prevention should receive continuous intense attention.     

Intentional injuries among the young: presentation to emergency rooms, hospitalization, and death in Israel

Purpose: To study the incidence and outcome of intentional injuries requiring emergency room (ER) care among children and adolescents in a national sample.

Method: The population included 0- to 17-year-olds who presented to the ER for injuries in 23 hospitals over a 1-year period. A 6% to 9% random sample of days was selected in each hospital, and for each selected day the relevant ER record was reviewed for cause, nature, and outcome of injuries and sociodemographic information.

Results: The annual incidence for intentional injuries resulting in ER visits was 19.6 in 10,000 children and adolescents aged 0 to 17 [95% confidence interval (CI) 17.4–21.8 in 10,000]. Fights/assaults constituted 54.1% of the presentations, abuse and rape, 10.3%, and self-inflicted injuries, 10.8%. Overall rates were higher among 10- to 17 year olds than at younger ages. The rates were higher among boys than girls for fights/assaults and abuse, whereas attempted suicide and rape were three times higher among girls than boys. Nearly twice as many Jewish children and adolescents presented to the ER for intentional injuries than Arab children and adolescents, with the ratio becoming even greater for attempted suicide.

Of all the intentionally injured, 21.7% were hospitalized. The mortality rate was 1.1 in 100,000 (95% CI = .7–1.7/100,00) with no significant gender difference observed. No cases of suicide were reported for the Arab population.

Conclusions: Adolescents aged 10 years and older are at higher risk for intentional injuries than younger children. The ethnic differences evident in this study, especially for attempted and completed suicide, may be real or the result of differential disclosure of information owing to sociocultural norms or differential recording by health professionals.     

深圳市儿童1型糖尿病发病率调查

目的:获得深圳地区儿童1型糖尿病(T1DM)年发病率资料,为进一步研究儿童糖尿病提供依据。方法:该研究采用捕获再捕获方法(Capture Recapture Method,CRM)回顾性调查深圳市所有1999年1月1日～2006年12月31日新发病的0～14岁T1DM儿童,按2000年深圳市人口普查公布的数据和2005年1%人口抽样调查数据的平均值作为1999～2006年的平均人口数计算年龄别和性别别年发病率。结果:1999～2006年共调查深圳市0～14岁儿童T1DM39例,男19例,女20例;平均年发病率为0.7370/10万,预计年发病率为0.7559/10万(95%CI:0.7181～0.7937/10万);8年中以2004年的发病率最高(1.9654/10万);以10～14岁组年发病率最高(1.2700/10万);男女性别间T1DM发病率(男:0.7145/10万,女:0.7598/10万)差别无统计学意义(χ2=0.04,P>0.05)。结论:深圳市儿童T1DM年发病率为0.7370/10万,预计年发病率为0.7559/10万(95%CI:0.7181～0.7937/10万),10～14岁组儿童T1DM发病率较高,男女性别间T1DM年发病率差别无统计学意义,与其它国家相比深圳市0～14岁儿童T1DM年发病率处于较低水平,而与国内其它城市相比,深圳市0～14岁儿童T1DM年发病率处于中等偏高水平。     

天津市2014年0~14岁儿童院内报告伤害流行特征分析

目的 了解天津市院内报告0~14岁儿童伤害监测病例的发生现状及其三间分布特征。方法 数据来源于覆盖天津市各级医疗卫生机构的发病监测体系,收集2014年1~12月全市241家哨点医院报告的首次伤害就诊病例资料。结果 0~14岁儿童伤害病例共报告34 297例,发生率为2 710.06/10万,男童发生率为3 319.66/10万,女童发生率为2 032.29/10万（χ2=1 983.329,P<0.001）。0~岁组发生率为2 613.42/10万,5~岁发生率为2 780.43/10万,10~14岁发生率为2 757.61/10万（χ2=28.242,P<0.001）。伤害发生地点最多为家中（占47.92%）。累及部位最多为头面部（9 787例,占28.5%）,其次为腕和手（8 009例,占23.4%）。76.3%为轻度伤害。在24种伤害原因中排在前5位的依次是:跌倒（42.44%）、动物伤（20.63%）、非机动车交通事故与机动车交通事故合计（9.16%）、砸伤（5.58%）、钝器伤（4.06%）。伤害发生以5月份（10.05%）和9月份（9.90%）最多;按季度来看为第二季度最高（29.23%）,且不同伤害类型在一年中的分布不同。结论 儿童伤害男童较女童发生率高,跌倒、动物伤、交通事故发生数量最高,5~岁发生率最高,5月和9月高发,应特别加强这方面的宣传教育和干预,多部门参与提高全社会安全意识。     

A prospective population based study of childhood injuries: the Velestino town study

BACKGROUND: Unintentional injuries in childhood constitute a significant public health problem. Our purpose is to estimate the incidence of identifiable unintentional childhood injuries of any type and severity, and to document risk factors of non-transient nature. METHODS: We have undertaken a prospective population-based investigation in a Greek town with a population of 748 children (0-14 years old). All identifiable injuries have been monitored during a twelve-month period through information provided by the health care outlets or educational institutions as well as the police station and the regional hospital. RESULTS: The overall incidence was 28.2 per 100 person-years (95% confidence interval from 24.4 to 32.0), whereas the incidence of injuries with Hopkins Injury Severity Score equal to or higher than four was 6.3 with 95% confidence interval 4.5 to 8.1. The incidence of total injuries was higher among boys than among girls (p<0.01) and the gender difference was particularly evident among older children. Almost half of the injuries were due to falls and more than 20% were due to cutting. Children of younger and less educated parents have higher risk for injury and children from families with more injuries were more likely to be injured themselves. There was no evidence that somatometric characteristics were associated with injury risk. CONCLUSION: The incidence of unintentional childhood injuries is high and represents a considerable health burden. Family related variables are important risk factors for childhood injuries, whereas somatometric characteristics play a minimal role. Key points: Incidence and risk factors of all injuries in a population-based study among children. About 28 per 100 children got injured over a period of one year. There is evidence that younger paternal age and lower education may be associated with increased injury risk. Family related variables seem to be important risk factors for childhood injuries, whereas somatometric characteristics play minimal role.     

4～14岁儿童意外损伤相关因素分析

目的 研究学龄期儿童意外损伤的危险因素,为制定有效的预防措施提供依据.方法 分析1994年1月1日～2004年12月31日收治的儿童意外损伤中4～14岁学龄期儿童病例的损伤类别、发生地点及时间、年份趋势及年龄、性别特点.结果 803例4～14岁学龄期儿童意外损伤占同期全部儿童意外损伤住院人数的59.52%.意外损伤的前四位原因是交通事故、意外跌落、烧烫伤和意外中毒.男女之比为1.95：1.全部统计的损伤中在学校发生的9.33%.交通事故损伤发生的地点以放学及上学路上最多,占全部交通事故损伤的33.30%,其他前三位发生地点以家内及家周围为多.意外损伤随年龄增长逐渐减少,女孩随年龄增长减少更为明显.交通事故及意外跌落伤在近5年有明显增多趋势.结论 学龄期儿童是意外损伤的高危人数,在年龄、性别及发生地点上有其特点.社会、学校及家庭应密切配合,制定有效的预防措施.     

广州市天河区0～14岁儿童伤害流行病学特征及影响因素分析

目的 探讨广州市天河区0～14岁儿童意外伤害流行病学特征及影响因素,为开展伤害预防干预提供依据。方法 以随机整群抽样的方法调查广州市天河区0～14岁儿童及其家长,以问卷方式调查儿童在过去一年意外伤害发生状况以及家长对意外伤害的认知水平。结果 共调查天河区1285名0～14岁儿童,其意外伤害发生率为16．34％,伤害次数发生率为20．47％,男、女性分别为23．46％和17.43％,男性高于女性(P＜0．01)。跌倒／坠落、碰撞／挤压伤、扭伤和交通事故是最常见类型,最常见的伤害地点是家里／宿舍、学校／幼儿园。2．66％的受伤儿童需住院治疗,44．87％的受伤儿童需医院门诊处理,意外伤害医疗费用支出占家庭人均月收入的14．53％。儿童意外伤害的影响因素为父亲职业、家庭经济状况及儿童性格特点等。95．2％的家长表示听说过“意外伤害”;89．4％的家长表示经常或有时担心孩子会发生伤害;13,4％的家长表示接受过有关预防儿童青少年伤害的培训和指导。结论意外伤害严重影响着天河区0～14岁儿童的健康,给家庭和社会造成经济损失。预防重点是培训家长和教师,开展健康教育,以提高其安全知识水平。     

Incidence and pattern of unintentional injuries and resulting disability among children under 5 years of age: results of the National Health Survey of Pakistan

National estimates of injuries for children under 5 years based on population representative surveys are not readily available globally and have not been reported for developing countries. This study estimated the annual incidence, pattern and distribution of unintentional injuries according to age, gender, socio‐economic status, urban/rural residence and disability caused among children aged under 5 years in Pakistan. The National Health Survey of Pakistan (NHSP 1990–94) is a nationally representative survey of households to assess the health profile of the country. A two‐stage stratified design was used to select 3223 children under 5 years of age for interview and examination. Data were used for boys and girls in urban and rural areas over the preceding year. A community development index was developed to assess the relationship between socio‐economic status and injuries. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software. Post hoc power calculations were made for each variable keeping the design effect at 3.0. The overall annual incidence of unintentional injuries was 47.8 [95% CI 36.6, 59.0] per 1000 per year; 50.2 [95% CI 37.0, 63.4] and 45.2 [95% CI 29.4, 61.0] per 1000 per year among boys and girls under 5 years of age respectively. An estimated 1.1 million unintentional injuries occur in Pakistan annually among these children. Injury rates increase with age among the under‐5s. Urban and rural injuries were 56.1 [95% CI 33.5, 78.7] and 44.1 [95% CI 31.1, 57.1] per 1000 per year respectively. The children living in least developed communities had almost 3 times higher risks of injuries than most developed communities. The annual incidence of types of injuries were: falls 28.7 [95% CI 19.5, 37.9], cuts/bruises 9.7 [95% CI 5.3, 14.1] and burns 6.6 [95% CI 3.0, 10.2] per 1000 per year. Falls were the most common type of injury (60%) followed by cuts/bruises (21%) and burns (14%). The majority of injuries occur at home (85%), with just 10% due to road traffic. Road traffic injuries and injuries to the female child were more likely to result in disability. There is a high burden of unintentional injuries and disability among children under 5 in Pakistan. These results are useful for planning further research and for prioritising prevention programmes nationally and in other developing countries with similar situation.