道路交通伤机动车碰撞类型比较研究

目的：研究道路交通伤的临床流行病学特点与机动车碰撞类型的关系。方法；将14779例由机动车碰撞所致的道路交通伤患者按其碰撞类型分组，对致伤方式、受伤部位、创伤严重程度、生理改变以及预测预后等方面进行比较和统计学分析。结果：机动车与行人和机动车碰撞为道路交通伤机动车主要碰撞类型，机动车与行人和摩托车碰撞致伤者损伤严重程度评分（ISS）分值较高，生存概率（Ps )预测值较低，且死亡所占比例较大（51．98％，92／177）；2个部位损伤为各种碰撞类型的主要受伤形式，其中头部及四肢骨骼伤较为常见，胸及腹部简明损伤定级（AIS）高会值伤较多；车外人员伤后生理紊乱较车内人员更为显著（P＜0．0）。结论：机动车所致的道路交通临床特点根据碰撞类型不同而有明显区别，高危伤情、高发部位及高危区为非对称性分布，机动车外交通伤比车内交通伤更为严重。

Comparative study on relationship between patterns of motor vehicle collision and road traffic trauma

Objective To study relationship between the feature of clinical epidemiology of the road traffic trauma and patterns of motor vehicle collision. Methods A total of 1 479 patients with road traffic trauma caused by motor vehicle collision were grouped by their patterns of collision; fashion, positon, severity, physiological change and prognosis of the injury in traffic accidents were compared and analyzed statistically. Results The main injury patterns were the collision of motor vehicle with pedestrian or the collision between motor vehicles. ISS of the patients involved in the collision of motor vehicle with pedestrian or with motorcycle was higher, survival probability (Ps) lower and mortality rate higer (51.98%) than that of the other patterns. The main injury fashion was 2 positons' injury in patients with road traffic trauma on patterns of all motor vehicle collisions, of which the injury on the head and osteoarticular position were commonly seen, high AIS of the chest and the abdomen was more; physiological disorder in patients out of vehicle was even more significant than that in those inside vehicle ( P <0.01). Conclusions Clinical features in patients with road traffic trauma caused by motor vehicle collision are different according to patterns of collision. Critical injury, position with higher occurence of injury and dangerous area of the patients are asymmetrical. The traffic trauma out of vehicle is more severe than that inside vehicle.