武汉市伤害住院儿童特征分析

目的以1993-2004年武汉市儿童医院意外伤害住院患者为研究对象,探讨伤害儿童的性别、年龄、损伤类型和损伤原因的特征.方法采用描述性分析方法,分析伤害住院儿童年龄、性别频数分布,损伤类型和损伤原因的性别、年龄特征.结果12939例意外伤害住院儿童中,损伤类型前四位是骨折、开放性损伤、软组织损伤和异物.损伤外部原因前四位依次是跌落、交通运输、呼吸道梗阻和挤压/撞击.意外损伤住院儿童男女性别比为2.1:1.0～5岁儿童占全部伤害住院儿童的66.0%;0岁组占全部伤害住院儿童的8.8%;1～2岁组占31.2%;3～5岁组占26.1%.随着年龄的增加,各年龄组患者的人数逐渐减少.结论近年来伤害正逐渐成为儿童的主要健康问题,不同性别、年龄儿童的损伤类型、损伤原因不同,应针对减少导致伤害的几种原因开展预防工作.     

意外损伤住院的6岁以下儿童相关因素分析

目的：研究6岁以下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：分析我院1994年1月1日-2004年12月31日收治的儿童意外损伤中6岁以下儿童病例的损伤类别、年龄、性别、住院时间及费用等特点。结果：741例6岁以下儿童意外损伤占同期儿童意外损伤总住院人数的55％。意外损伤的前4位原因是烧、烫伤、意外跌落、交通事故和意外中毒。男女比为1．65：1。烧、烫伤随年龄增长明显减少，而交通事故伤随年龄增长逐渐增多。住院费用最高及住院时间最长的是交通事故伤。结论：6岁以下儿童是意外损伤的高危人群，在年龄、性别及意外损伤类别上有其特点。社会、学校及家庭应密切配合，研究儿童意外损伤的各种危险因素，制定有效的预防措施。     

1996～2000年住院儿童意外损伤的调查分析

目的：了解本地区儿童意外损伤发生的特点，为开展意外损伤控制提供科学依据。方法：对1996年1月1日到2000年12月31日我院772例意外损伤患儿的临床资料进行统计分析。结果：意外损伤患儿占周期0－14岁儿童住院病例的8．13％（772／9496）；死亡21例，伤亡率2．72％（21／772）。儿童意外损伤死亡居我院0－14岁儿童死因顺位之首。772例患儿男女之比为5．43：1。不同年龄段损伤类型的构成不同，1－5岁年龄段烫伤构成比最高22．6％（61／270），其次是意外跌落17．4％（47／270）和中毒17．0％（46／270）。6岁－14岁儿童均以交通事故损伤构成比最大，分别为34．7％（78／225）和40．2％（107／266），其次为切割、碰撞、运动损伤等自伤，分别为24．4％（55／225）和22．2％（59／266）。10－14岁儿童因打架斗殴等造成的他伤较小年龄组有增高趋势，构成比为18．8％（50／266）。结论：开展意外损伤控制在1－5岁年龄段重点是加强幼儿教师及家长相应的监护措施，可由幼儿园和社区卫生保健机构负责对教师和家长的培训指导。同时对儿童进行安全教育，对6岁以上学龄儿童，社区、学校、家长互相配合对中小学生进行交通安全及自我防护教育，同时加强道路交通安全管理。对10－14岁儿童还应加强心理卫生健康教育，针对该年龄段情绪不稳定，遇事不冷静等情况，家长和老师应及时疏导，防患于未然，就可减少儿童意外损伤的发生。     

住院儿童意外伤害的城乡差别分析

【目的】了解0～14岁意外伤害住院患儿城乡特征、伤害类型、入院严重程度和转归。【方法】以湖南省儿童医院2002～2003年两年0～14岁的意外伤害住院儿童487例作为研究对象，对其基本特征进行描述性统计分析。【结果】本研究的487例0～14岁意外伤害的住院儿童占全部住院儿童的2．21％，来自农村者占59．8％，城市儿童占40．2％，农村儿童异物和中毒多于城市儿童。病情严重程度相对较重，男童跌落伤和机械伤多于女童,且病情较严重。【结论】意外伤害住院儿童病情均较重，与年龄、忡别、城乡住址、伤吉部位和类喇密切相关，若能住院及时抢救，可获得良好转归。     

婴幼儿意外伤害住院病例分析

目的：分析造成婴幼儿意外伤害的主要原因并提出预防措施。方法统计青岛市立医院2005年1月1日至2011年12月31日因意外伤害住院的283例0～3岁婴幼儿病例。按照损伤类型对比构成情况、年龄、性别、城乡分布、住院时间与住院费用。结果造成婴幼儿意外伤害的主要原因为烧烫伤和气管异物,构成比例分别为61．13％和33．57％。意外伤害多发生于13～24月的幼儿,占到全部病例的59．36％,烧烫伤、气管异物两类意外伤害中,除0～6月与7～12月两年龄组比较无统计学意义外,其他各年龄组间比较均有统计学意义（如7～12月与25～36月两年龄段分布比较,u＝3．810,P＜0．05;u＝4．017,P＜0．05）。性别分布为男：女为1．95：1,男童与女童在烧烫伤、气管异物两类意外伤害中比较有统计学意义（ u＝3．269,P＜0．05;u ＝4．617,P＜0．05）。城乡分布城市：农村为115：168＝0．68,城市患儿与农村患儿在烧烫伤、气管异物两类意外伤害中比较差异有统计学意义（ u＝2．509,P＜0．05;u＝2．155,P＜0．05）。意外伤害的医疗费用较高,除气管异物外均在20000元以上。结论意外伤害住院儿童损害严重,花费昂贵,增加了儿童家庭的经济负担,因此做好烧烫伤、气管异物、意外坠落等儿童意外伤害的预防工作十分重要。     

741例住院儿童意外损伤因素分析

目的了解本地区儿童意外损伤发生的特点，为制定预防儿童意外损伤措施提供依据。方法对0～14岁少年儿童意外损伤741例病案资料的年龄、性别、损伤类别及居住环境进行分析。结果741例意外损伤儿童占同期住院儿童的9．32％，病死率1．21％，男女之比为1．6：1。交通事故是意外损伤的首要原因。各类意外损伤发生在不同年龄段有明显特点：交通事故多发生在7岁以下，占85．46％；跌落伤多发生在3岁以下，占53．38％；中毒多发生在7岁以下，占59．59％；烧、烫伤多发生在3岁以下，占93％；3例性伤害全部是10岁以下。总之各类伤害多发生在学龄前儿童，而且农村儿童意外伤害多于城镇儿童。经检验，=23．08，P〈0．05。结论农村儿童发生意外损伤多于城镇儿童，学龄前儿童多于学龄期儿童。各类损伤的发生在不同年龄、性别和生存环境有明显特点，社会、学校、家庭应重视儿童意外损伤已显得十分必要，特别是对农村及学龄前儿童采取相应预防、安全教育等干预措施，加强道路安全管理及监护，消除某些可能发生意外的危险因素，控制儿童意外伤害的发生，保证儿童生命安全和健康成长。     

垂杨柳医院儿童意外损伤资料分析

目的：了解城乡结合部儿童意外损伤的原因及危险因素。方法：对我院1998年4月－2000年12月意外损伤的96例儿童进行回顾性分析。结果：儿童意外损伤,城市前3位为动物致伤,中毒和跌落伤,分别为42．9％,21．4％和17．8％,农村为中毒,动物致伤和烫伤,分别为55．7％,8．6％和7．1％,中毒农村高于城市,动物致伤和跌落伤城市高于农村,2者比较差异有显著性（P＜0．01）,中毒城市乡均以一氧化碳为首位,其次,城市以药物,农村以有机磷和灭鼠药为主,3岁前儿童意外损伤以窒息和气管异物为主,3岁以上以动物致伤和跌落伤为主;意外损伤致死23例,占意外损伤儿童的23．5％（23／98）,致死原因主要为车祸和溺水。结论：城乡结合部儿童重点预防中毒,动物致伤,跌落伤和烫伤,同时防止车祸和溺水导致儿童意外死亡。     

儿童意外伤害住院的情况调查

目的 了解儿童意外伤害的发生状况,为儿童意外伤害的预防和干预提供参考依据。方法 对收住院的2960例意外伤害儿童的病案首页进行统计,分析其损伤类别及损伤原因、构成、年龄、性别、地区分布。结果 2960例意外伤害住院患儿中有991例骨折（占33．5％）,609例烧伤／烫伤（占20．6％）,536例内脏损伤（占18．1％）,291例开放性损伤（占9．8％）。男女比例为2．2：1。各类意外伤害年龄特点:烫伤3岁以下占51．2％,0－1岁是发病高峰年龄段,占33．7％;骨折多发生于3岁以上,占91．6％,而以6－14岁为最多,占69．3％;交通事故6－14岁为高峰年龄组,占66．7％;意外坠落多发年龄段是6岁以上,占65．1％,年龄跨度最大。各类损伤住院总费用为3938583．5元,人均1330．6元;总住院日为50778天,人均17．2天。结论 各类损伤的发生在不同年龄段、不同性别、不同地区间有着明显特点。     

1349例意外损伤住院儿童分析

目的:分析儿童意外损伤的类别及相关因素。方法:对1349例儿童意外损伤住院病例按国际损伤分类标准,对损伤类别、构成、年龄、性别、住院费用及天数进行分析。结果:儿童意外损伤占同期住院患儿及全部意外损伤住院人数的8%,是导致同期1月以上年龄住院患儿死亡的第1位原因。儿童意外损伤的前4位原因是交通事故、意外跌落、烧烫伤和意外中毒。男女比为1.79∶1。交通事故和意外跌落高峰年龄段在4～9岁,烧烫伤和意外中毒主要发生在3岁前。其中交通事故的平均住院费用最高,平均住院时间最长。坠落物致伤及机器致伤也占一定比例,分别为3.92%和1.33%。结论:应当大力开展儿童意外损伤危险因素的识别和干预,以减少儿童意外损伤的发生。     

北京杭州儿童意外伤害烧伤居首位

2005年2月4日，卫生部公布了去年对北京和杭州市7所医院0～6岁649名儿童因意外伤害住院的情况调查结果。其中烧烫伤占39．0％，气管异物占29．9％，跌落伤占22.6％，药物和化学品中毒占8．5％。意外伤害高发年龄在1岁半至3岁，发生地点是在家中，男童明显高于女童。调查原因分析，90．8％的烧烫伤是由于开水、热水、     

School Injury Among Ottawa-Area Children: A Population-Based Study

BACKGROUND:  Injuries are the leading cause of death among Canadian children and are responsible for a substantial proportion of hospitalizations and emergency department visits. This investigation sought to identify the factors associated with the likelihood of sustaining an injury at school among Ottawa-area children.
METHODS:  Children presenting to Ottawa-area hospitals and urgent care clinics from January to December 2002 (n = 24,074) were included for analysis. The frequency of school injuries by sex, age group, type of injury, and hospitalization was analyzed. Multivariate logistic regression was used to assess the factors associated with sustaining an injury at school. The school activities most associated with injury and the most frequent types of school injuries were assessed.
RESULTS:  A total of 4287 Ottawa-area children were injured at school in 2002, representing 18% of all injuries. Children aged 5-9 years and 10-14 years were more likely to have school injuries than older children (aged 15-19 years) (OR = 3.07, 95% CI = 2.77-3.40 and OR = 3.10, 95% CI = 2.83-3.37, respectively). The most frequently encountered school injuries were fractures (n = 1132) and musculoskeletal injury (n = 907). The most frequent mechanisms of school injuries were "playing" (n = 1004) and "informal sports" (n = 1503).
CONCLUSIONS:  Many children get hurt at school, particularly during informal recreation activities. Environmental modification and increased supervision are strategies that may reduce school injuries.     

Prevalence and risk factors associated with work-related eye injuries in Bosnia and Herzegovina

Background: Eye injuries are a prevalent workplace injury and cause substantial disability when vision is impaired.

Objective: To examine work-relatedness of demographic, injury, and clinical characteristics of eye injuries in a large clinic in Bosnia and Herzegovina.

Methods: We performed a nine-year retrospective study of patients admitted with an eye injury to the Canton Hospital in Zenica, Bosnia and Herzeogvina. Controlling for age and sex, we used logistic regression to examine the influence of work-relatedness on patient and injury characteristics and clinical outcomes.

Results: Of 258 patients, 71 (27.5%) had work-related and 180 (69.8%) had non-work-related eye injuries. Work-related eye injury was associated with age, education, occupation, and injury type. Agricultural workers were eight times more likely to experience work-related eye injury (95%CI = 1.21–152.0) compared to manual workers. Work-relatedness of injury did not predict final visual acuity or length of hospital stay.

Conclusion: Promotion of eye safety is needed countrywide. Occupational eye protection is a priority due to the relatively proportion of eye injuries and the workplace being a relatively controlled environment.     

Tractor-related injuries: a population-based study of a five-state region in the Midwest

BACKGROUND: Tractor-related injuries are among the most severe of agricultural injuries. This study identifies the incidence, consequences, and potential risk factors for tractor injuries among 3,765 agricultural households in a five-state region. METHODS: Demographic, injury, and exposure data were collected for two 6-month recall periods in 1999 using computer assisted telephone interviews. A causal model served as a basis for survey design, data analysis, and interpretation of results; associated directed acyclic graphs guided development of multivariate models. RESULTS: The overall injury rate was 9.6 events per 1,000 persons per year. Increased personal risk was observed for males and prior agricultural injury experience. Compared with ages 35-44, decreased risks were identified for those less than 5, 5-9, 10-14, 15-19, and 20-24. CONCLUSIONS: Risk of tractor injury among agricultural household members varied by gender, age, and prior injury experience. .     

Three times the injuries among occasional wood cutters compared to professional loggers: sample of emergency rooms in central and northern Wisconsin

BACKGROUND: No reliable statistics exist for injury rates among occasional woodcutters as opposed to professional loggers. Study objectives were to assess woodcutting injuries seen in emergency rooms and identify risk factors. METHODS: Individuals with woodcutting related injuries were identified in 14 emergency and urgent care departments in central and northern Wisconsin. A telephone survey was conducted within 3 weeks of presentation to determine number and types of injuries, causes, and characteristics of the injured. RESULTS: Three times as many woodcutting-related injuries occurred in non-logger survey participants (54 vs. 17). There was no significant difference in age or type of injury. Loggers were more likely to wear personal protective equipment. Younger individuals attributed their accidents to human errors, whereas older individuals felt their injuries were unavoidable. CONCLUSIONS: Occasional woodcutting activities result in comparable, but more frequent injuries than professional logging activities. Further data are needed to assess impact on public safety.     

颅脑火器伤的判断与救治

目的分析总结颅脑火器伤的临床特点。方法对31年内共收治的201例颅脑火器伤病例进行分析。结果男179例,女22例;盲管伤119例,贯通伤70例,浅切线伤7例,颅面联合伤5例;早期合并症主要有脑挫裂伤88.6％,颅内血肿19.4％,感染21.0％。晚期合并症主要有异物存留、癫痫等。死亡26例,死亡率12.94％。结论火器性投射物具有强大的压力波,能产生较大的瞬时伤道,可对颅脑造成严重而广泛的损伤,不能用一般颅脑外伤的致伤原理和经验来诊治火器性颅脑伤。早期准确判断、彻底清创、注意手术方法的选择和手术要点的掌握、尽量减少脑组织的继发损伤、防止各种并发症是降低死亡及残废率的关键。