“7.23"温州动车事故伤员伤情特点及救治分析

目的 总结并分析“7.23”温州动车事故伤员伤情特点,探索救治经验. 方法 以“7.23”温州动车事故生存和死亡伤员共177例为研究对象,分析伤员的年龄、性别、致伤原因、损伤部位、损伤严重程度等信息,并输入由第三军医大学中华创伤数据库中心研制的创伤数据库系统V3.0进行评分和分析. 结果 事故后24 h内共收治伤员137例,男76例,女61例,性别差异无统计学意义;其中生存136例,救治无效死亡1例;撞击伤、挤压伤及重物坠落砸伤是主要的致伤原因;生存伤员中,多发伤108例(79.4％);所有生存多发伤伤员中,以胸部、头部和四肢分列为第一、第二和第三位常见受伤部位;TI分值最小5分,最大27分.TI分值≤9分4例(3.7％),10 ～ 16分86例(79.6％),≥17分18例(16.7％).ISS＜ 16分的伤员78例(72.2％),ISS≥16分的伤员30例(27.8％),其中ISS分值最小3分,最大75分.共死亡40例(包括入院后救治无效死亡1例),死亡伤员均为多发伤,颅脑损伤为第1位死亡原因. 结论 本次动车追尾事故伤因复杂,多发伤发生率高;损伤程度不一,但总体情况较轻;常见损伤部位分布在生存伤员和死亡伤员中存在显著差异;应根据这些伤情特点采取有针对性的现场检伤分类、逐级转运、专科救治.     

北京市“120"救治0～25岁人群交通伤特点分析

目的 了解北京市“120”救治的0～25岁青少年及儿童2004-2009年道路交通事故( RTA)伤情特点,为制订预防和控制交通伤害的有效措施提供科学依据. 方法 收集北京市“120”急救中心2004-2009年转运救治的0～25岁青少年及儿童道路交通事故患者性别、年龄、事故发生时间、受伤部位、受伤成员和死亡患者等进行回顾性分析. 结果 (1)2004-2009年交通伤患者共17 232例,院前死亡259例.其中0～ 25岁青少年及儿童道路交通伤4 229例(24.5％),年龄(20.13±4.43)岁.随着年龄的增加,患者数量呈现明显上升趋势,其中20岁的患者数量明显多于其他年龄组.(2)患者中男2 252例,女1 677例,男女比例约为1∶5∶1(P＜0.05).(3)随着时间的发展,各年的受伤患者数量呈下降趋势.1年当中5,9,10月份事故高发;1周中周五到周日发生率较高,周二较低(P＞0.05).1天当中,以20:00～23:00事故最多,3:00 ～6:00事故数量最少(P＜0.05).(4)受伤部位以四肢关节伤多见(53.4％),其次为头颈部外伤(35％),受伤者多为行人(49.1％).(5)死亡38例,其中男28例,女10例,年龄( 19.29±5.30)岁.33例(87％)死亡由颅脑损伤所致,主要发生在7,8月份. 结论 青少年及儿童交通事故伤的情况不容忽视,进一步加强交通安全教育,适当增强交通高峰时段的执法力度,提高院前急救的配合,可能对减少青少年及儿童伤害起到积极的作用.     

Occupational Accidents with Agricultural Machinery in Austria

The number of recognized accidents with fatalities during agricultural and forestry work, despite better technology and coordinated prevention and trainings, is still very high in Austria. The accident scenarios in which people are injured are very different on farms. The common causes of accidents in agriculture and forestry are the loss of control of machine, means of transport or handling equipment, hand-held tool, and object or animal, followed by slipping, stumbling and falling, breakage, bursting, splitting, slipping, fall, and collapse of material agent. In the literature, a number of studies of general (machine- and animal-related accidents) and specific (machine-related accidents) agricultural and forestry accident situations can be found that refer to different databases. From the database Data of the Austrian Workers Compensation Board (AUVA) about occupational accidents with different agricultural machinery over the period 2008–2010 in Austria, main characteristics of the accident, the victim, and the employer as well as variables on causes and circumstances by frequency and contexts of parameters were statistically analyzed by employing the chi-square test and odds ratio. The aim of the study was to determine the information content and quality of the European Statistics on Accidents at Work (ESAW) variables to evaluate safety gaps and risks as well as the accidental man-machine interaction.     

The role of NGOs in child injury prevention: An organizational assessment of one network of NGOs

Unintentional injuries are estimated to claim the lives of more than 875,000 children each year; millions more live with long-term consequences and permanent disabilities. The epidemiology of injuries has become clearer in the past decade. NGOs need to work in concert with each other to address the global burden of injuries by sharing information. Several NGOs have heeded this call, and the field has seen the emergence of global organizations aimed at highlighting the burden of injuries and streamlining injury prevention activities worldwide. Safe Kids Worldwide Inc. (SKWW) is a global network in 16 countries whose mission is to address the burden of injuries in children under 15 by harnessing the potential of local NGOs. An organizational assessment was conducted of SKWW which included structured organizational assessment, functional organizational mapping and contextual analysis that allowed for an in-depth examination of the strengths and challenges of SKWW's injury prevention approach. Over one year, primary and secondary data were collected and analyzed from headquarters and individual country offices. SKWW appears to be an effective model and has experienced a strong momentum and growth over the last two decades. Global NGOs that address the burden of injuries should start by defining a clear and universal strategic goal, build on local successes, maximize their strengths, and create avenues for stronger country engagement.     

长治市小学生道路交通安全问题现况调查

目的 调查分析长治市小学生道路交通安全知识、态度、行为状况,及家庭、学校、社会等因素对其的影响,为有针对性地开展交通伤害预防和控制工作提供依据.方法 采用整群随机抽样的方法,在长治市随机抽取11所小学,每所学校的四至六年级各随机抽取一个班,利用统一问卷进行调查.结果 小学生道路交通安全知识得分P50为80分,小学生道路交通安全行为得分P50为94分.家长平日里是否教学生安全知识与学生交通安全知识得分有关;家长交通行为与学生交通行为有关.多因素Logistic回归分析提示:除学生行为得分(OR =2.046,95％ CI:1.518 ～2.759)外,父母自身的交通行为对发生车祸的影响最为显著.结论 长治市小学生道路交通安全问题严峻,家长责任重大.     

Trauma in Cirrhosis: An Indicator of the Pattern of Alcohol Abuse in Different Societies

While some morbidities associated with the excessive use of alcohol are related to the total amount of alcohol consumed--cirrhosis being an example--other pathologies, such as trauma and those of psycho-social origin, are mainly related to the frequency of acute alcoholic intoxication rather than to the total amount consumed. The balance between these two types of alcohol-associated morbidities can provide an indication of the relative frequency of intoxication, and thus of the pattern of alcohol abuse in a population. Since trauma is highly associated with acute alcoholic intoxication, the prevalence of bone fractures was determined in cirrhotics in nine countries. The prevalence of rib and vertebral fractures on routine chest x-rays showed a 17-fold variation in the different countries, from 2% and 6% in Spain and Italy to 30% and 34% in Canada and the USA, suggesting marked differences in the pattern of alcohol abuse to intoxication. Conversely, the prevalence of cirrhosis is twice as high in Spain and Italy than in Canada and the USA. A strong positive correlation between per capita consumption and cirrhosis mortality (r = 0.86; p less than 0.01) exists among the nine countries studied, while the correlation between per capita alcohol consumption and the prevalence of trauma is not statistically significant (r = 0.40). Supporting a strong association between trauma and alcoholic intoxication, the prevalence of trauma was found to be highly correlated: r = 0.88, p less than 0.002, with the degree of concern for the psycho-social consequences of alcohol abuse in the different countries. Data indicate that trauma can be used as an objective indicator to assess the pattern of alcohol abuse in a population.     

Accidents vasculaires cérébraux ischémiques transitoires récurrents chez une jeune patiente secondaire à un fibroélastome papillaire de la valve mitrale et une hyperhomocystéïnémie. À propos d’une observation

We describe a case of a young patient admitted for recurrent ischemic stroke caused by a papillary fibroelastoma of the mitral valve and a hyperhomocysteinemia. A papillary fibroelastoma is a benign cardiac tumor which can be associated with serious embolic complications. A moderate plasma level of hyperhomocysteinemia is considered as a risk factor of ischemic stroke. The authors suggest that this association increases the risk of ischemic stroke in their patient. The tumor was surgically removed to avoid new embolic events associated with a vitamin B supplementation. After surgery and acid folic supplementation, no recurrence was observed.