深圳市宝安区2011~2014年772例交通伤死亡分析

目的：研究近4年深圳市宝安区772例道路交通伤死亡的流行病学特点,为本市区交通伤预防、安全宣教及科学救治提供科学依据。方法回顾性研究2011年1月至2014年12月经深圳市交警处理的交通伤数据,通过统计学分析深圳市宝安区近4年772例交通事故后24小时内致死患者发生的时间分布情况(年份、月份、日期及发生时间等);空间分布情况(发生路口路段、道路类型等);交通伤患者死亡情况(死亡患者类型、受伤类型等)。结果2011~2014年深圳市宝安区共发生道路交通伤24小时内致死患者772例,呈逐年递减趋势,其中2011年276例、2012年183例、2013年174例、2014年139例;交通伤致死患者中男594例,女178例,男女比例为3.32：1;交通伤致死患者中<18岁91例,18~40岁376例,41~65岁271例,>65岁34例;交通伤致死患者中主因颅脑损伤致死患者613例(79.4%),主因胸腹脏器损伤致死患者133例(17.2%),主因失血性休克26例(3.4%);交通伤致死患者中行人158例(20.5%),自行车骑乘人员252例(32.6%),摩托车驾驶人员133例(17.2%),机动车驾驶员或乘客229例(29.7%)。结论深圳市宝安区近4年交通伤致死率仍处于较高水平,行人、自行车及摩托车骑乘人员是主要致死人群,颅脑损伤是主要致死原因,应当加强交通安全教育,制定科学的防范措施,鼓励自行车及摩托车骑乘人员佩戴安全头盔是有效降低本区域交通伤致死的重要措施。     

北京城区院前救治的道路交通损伤特点分析

目的:描述北京急救中心2004年1月1日至2010年12月31日救治城区道路交通损伤的现状,总结其社会学特点,并初步探讨其可能的改善方法.方法:所有数据来源于北京市统计局和北京急救中心病案室,在收集后者数据时检索并录入2004年1月1日至2010年12月31日共7年期间由北京急救中心参与救治的道路交通损伤病例,应用Excel 2007、SPSS 17.0进行方差分析及卡方检验.结果:共收集符合准入标准的完整病例19 550例,道路交通伤的年发病率约为120人/10万人,死亡率约为4.97人/10万人,其中男性(11 737,60.04％)明显多于女性(7 813,39.96％),平均年龄(38.76±16.84)岁.各年龄组交通伤均多发于每年的10月份,日间多于夜间,以中午前、后最多,但不同年龄患者交通损伤发生的每日时间分布特点不同.受伤者多为行人(7 588,38.81％)和骑自行车者(3 790,19.39％),发生部位多在头面(8 343,42.68％)和下肢(6 828,34.93％),损伤程度以中等损伤为主(11 718,59.94％),造成损伤的一方多为小型汽车(11 490,58.77％).结论:防治道路交通损伤,需要针对不同人群、不同时段和不同交通方式,采用不同的管理方法和规范化的院前救治.     

中美急诊道路交通伤患者流行病学研究

目的 阐明中美两国综合性医院急诊医学科道路交通伤患者的异同点,为两国在道路交通伤临床、教学和科研方面的进一步合作提供新思路。方法 选取2013年11-12月中国浙江省人民医院急诊医学科和2013年7-9月美国纽约州立大学上州医科大学急诊医学科两家单位的道路交通伤患者作为调查对象。双方合作设计《MVC Survey Questionare》（中英文版）,供两家单位开展问卷调查。调查方法为标准流行病学抽样调查。调查内容包括患者到达急诊医学科的方式、交通工具、损伤类型、影像学检查情况、会诊情况、转归等。结果 共发放问卷425份,回收合格问卷399份,有效率为93.9%,其中中国有效问卷155份,美国244份。到达急诊医学科的方式：美国道路交通伤患者救护车使用率高于中国,自备车使用率低于中国（P＜0.05）。交通工具：美国自行车、电动车、行人交通事故发生率低于中国,汽车交通事故发生率高于中国（P＜0.05）。损伤类型：美国患者颅脑、皮肤软组织损伤发生率低于中国,胸部损伤、骨折发生率高于中国（P＜0.05）。影像学检查：美国患者X线、CT检查率均高于中国（P＜0.05）。两国住院率、病死率、救治成功出院率、入住ICU比例、急诊手术率比较,差异均无统计学意义（P＞0.05）。结论 与美国相比,中国较少选择救护车转运道路交通伤患者。中国有更多类型的机动车涉及道路交通伤事故,中国道路交通伤患者中骑电动车、摩托车和行人的比例较高,这在一定程度上导致了中国颅脑损伤的比例远高于美国。另外,中国患者影像学检查率明显低于美国。上述差异为未来双方在道路交通伤临床、教学和科研方面开展进一步合作提供了新思路。     

深圳市宝安区2004年至2011年道路交通事故伤的特点分析

目的：了解2004年至2011年深圳市宝安区交通伤的分布特点,为本市交通伤预防提供科学依据。方法：回顾性分析2004年1月至2011年12月经深圳市交警处理的交通事故数据,统计深圳市宝安区近8年交通事故发生的时间分布情况（年份、月份、日期及发生时间）、空间分布情况（发生路口路段及道路类型等）、交通事故患者伤亡情况（受伤、致死）。结果：2004年至2011年深圳市宝安区共发生道路交通事故422 730起,受伤63 809人,死亡2 790人,受伤/死亡比率为22.87∶1。宝安区交通事故发生数呈递增趋势,2010年发生数最高,达90 358起;2007年因交通事故致死人数最多,达473人。按月份统计,8月份交通事故发生率最高（9.77%）,2月份最低（5.39%）;12月份交通事故致死人数最多（9.02%）。按发生时间统计,一天中交通事故的发生高峰时间为9∶00至11∶00及15∶00至18∶00,而凌晨3∶00至6∶00交通事故发生数较低。交通事故多发生于路口路段、平直路线、城市主干道及仅有标示、标线的路段。结论：针对区域性交通事故发生特点,提高全民交通安全防范意识,合理调配急救人员、交通管理人员等人力资源,制定科学的防范措施,改进急救体系和服务模式,是预防和控制交通伤害的重要措施。     

高速公路行人交通伤特点分析

目的　探讨高速公路行人交通伤特点。方法　对广深高速公路 1998～ 2 0 0 0年 3年间 2 4 84起交通事故中 4 2起车 -人交通事故伤的病例资料进行分析统计。结果　 2 4 84起交通事故中死亡 12 8例 ,伤 812例 ,其中4 2起车 -人交通事故中死亡 34例 ,占死亡总数的 2 6 . 6 % (34/ 12 8) ,伤 8例 ,车 -人交通事故死亡率为 81. 0 % (34/ 4 2 ) ,死亡平均年龄 31岁 ,死亡患者中有 6 7 .6 % (2 3/ 34)现场死亡 ,17例为多发伤 ,ISS评分为 4 2分 ,事故发生时间 14 :0 0～ 2 2 :0 0共发生 30起 ,占 71 4 % (30 / 4 2 ) ,4 2例伤亡人群中 ,共有 34例合并有颅脑损伤 ,占 81 .0 % (34/ 4 2 )。结论　广深高速公路行人交通伤具有时间的聚集性 ,伤情重 ,死亡率高 ,颅脑损伤的发生率高 ,加强全社会高速公路的法律法规学习 ,对减少高速公路行人交通伤的发生具有显著意义。     

144例道路交通伤患者的智力和社会适应能力鉴定资料分析

目的探讨因道路交通事故所致颅脑损伤患者的智力和社会适应能力的变化。方法采用SPSS 13.0统计软件,对2008年8月至2010年12月144例颅脑损伤患者的韦氏智商和社会适应能力测查资料进行描述性统计分析。结果 144例患者的平均智商为（68.54±17.87）,69例患者（47.92%）存在轻度至极重度智力缺损。128例患者（88.89%）的适应行为评分低于正常,平均分为（5.65±2.73）。结论颅脑损伤的道路交通伤患者多伴有不同的程度智力和社会适应能力的损害。     

张掖市22642例交通伤患者的流行病学分析

目的 通过对交通伤患者的发生情况和原因进行分析,探讨急诊交通伤的流行病学特点,制订科学的防范措施,降低交通事故的发生,保障人民群众生命安全.方法 选择2003年1月-2010年12月在张掖市各医院急诊就诊的交通伤患者22 642例,按年龄、月份、外伤类型、受伤原因等分类,并进行回顾性分析.结果 (1)按受伤者年龄分布统计:≤15岁的1 952例,占8.6％; 16～55岁的18 277例,占80.7％;≥56岁的2 413例,占10.7％.(2)按月份统计:5-10月交通伤发生病例数最多,15 274例,占67.5％.(3)按损伤部位统计:交通伤中损伤部位最多的为颅脑和各种软组织损伤,分别占总数的34.6％和27.3％.(4)按发生年份统计:近年来由于交通事故导致的各种外伤病例比例有逐年增高的趋势,但自2008年以后逐渐平缓.(5)按驾驶类别统计:交通伤患者主要发生在摩托车驾驶员人群,共8 793例,占总数的38.8％.结论 通过对交通伤的流行病学分析,掌握交通伤发生的规律,采取必要的预防措施;加强公路交通管理,严禁违规行车;强化教育管理,提高驾驶员和行人安全意识;建立健全医疗急救网络,加强对重型颅脑损伤的救治等,是降低公路交通事故伤害的主要措施.     

坠落伤与交通事故伤患者创伤部位及抢救效果比较

目的：探讨交通事故伤与坠落伤创伤部位的差异、抢救方案和效果。方法：回顾性分析160例由坠落伤与交通事故伤导致的脊柱骨折患者的临床资料,记录患者的致伤原因、骨折部位、骨折类型、救治措施,评价其治疗效果。结果：坠落伤以椎弓根骨折、椎板骨折、小关节骨折多见,高于交通致伤骨折（P＜0.05）;交通致伤骨折类型则多为爆裂骨折与压缩骨折,坠落伤脊髓损伤分级多为C级,高于交通事故伤的10.2%。交通事故伤以A级、B级、E级骨髓损伤常见,其中A、E级所占比例高于坠落伤（P＜0.05）;交通事故伤患者治疗总有效率与坠落伤对比差异无统计学意义（P＞0.05）。结论：多节段脊柱骨折有其复杂性特征,在临床诊断、急救及治疗方式的确立方面需从致伤原因、损伤类型等方面作综合性考虑。     

2018年某院道路交通伤害病人的情况分析

目的分析2018年深圳某医院道路交通伤害患者特点,探讨道路伤害患者的情况。方法回顾性分析2018年435例道路交通伤害患者的数据。结果 435例道路交通伤害患者中,男性患者占64.83%,女性患者占35.17%,男性高于女性;患者年龄主要集中在20-50岁,且以行人和机动车人员损伤为主。结论男性是高危人群,应加强他们交通安全知识,提高他们的自我保护意识。对违反交通法规的行人和非机动车人员也不能过度保护,最好能实行批评教育,以提高他们遵守交通规则的意识,降低交通事故率。     

763例口腔颌面部损伤的临床流行病学特点

目的分析763例口腔颌面部损伤患者的临床流行病学特点。方法对1984年1月~2004年5月口腔颌面外科住院的763例颌面部损伤病例进行回顾性分析。结果口腔颌面部损伤患者人数占住院总人数的14.3%,男、女比例为3.51∶1,20~40岁为发病高峰年龄段;交通事故在致伤原因中居首位,占42.99%;颌面损伤以骨折为主,其中下颌骨骨折最为常见;颅脑损伤是颌面骨折最常见的合并伤;交通伤和面中部骨折具有较高的损伤严重度评分。结论男性青壮年为颌面损伤高发人群,交通事故是颌面部损伤的主要原因,常造成颌面部多发性骨折并可合并颅脑损伤。     

Road traffic deaths, injuries and disabilities in India: current scenario

In 2005, road traffic injuries resulted in the death of an estimated 110,000 persons, 2.5 million hospitalizations, 8-9 million minor injuries and economic losses to the tune of 3% of the gross domestic product (GDP) in India. If the present trend continues, India will witness the deaths of 150,000 persons and hospitalization of 3 million people annually by 2010, increasing further to 200,000 deaths and more than 3.5 million hospitalizations annually by 2015. Nearly 10%-30% of hospital registrations are due to road traffic injuries and a majority of these people have varying levels of disabilities. A majority of victims of road traffic injuries are men in the age group of 15-44 years and belong to the poorer sections of society. Also, a vast majority of those killed and injured are pedestrians, motorcyclists and pillions riders, and bicyclists. A clearly defined road safety policy, a central coordinating agency, allocation of adequate resources, strict implementation of proven and effective interventions and reliable information systems are urgently required. Greater participation from health and other sectors based on an integrated, intersectoral and coordinated approach is essential. Health professionals can contribute in numerous ways and should take a lead role in reducing the burden of road traffic injuries in India.     

Biomechanics of road traffic collision injuries: a clinician's perspective

Understanding the biomechanics of road traffic collision injuries is important for diagnosing and managing road traffic injured patients. As road traffic collisions may entail high-energy trauma, the degree of injury will depend on the mass and speed of the collided vehicles. Collisions can be front impact, back impact, side impact; the vehicle may turn over or the patient may be ejected from the vehicle. Each of these mechanisms has a specific pattern of injury. The injury will vary depending on whether the passenger was restrained with a seat belt or not. Seat belts tend to reduce head injuries and increase the abdominal injuries. Compression injuries of the intestines and urinary bladder tend to be more severe, causing rupture of these hollow organs if pressure within these organs was high. Pedestrian injuries consist of three phases: the bumper impact, hood and windscreen impact, and ground impact. The injury pattern and impact of motor vehicle collisions with large animals will depend on the size, height and weight of the animal. Clinical examples of road traffic collision patients will highlight the value of understanding biomechanics in patient management.     

Health service needs of women with reproductive tract infections in selected areas of China

Objective To provide insight into the psychosocial factors underlying the utilisation of health services by women with reproductive tract infection (RTI) symptoms.Methods A cross- sectional study, adopting Aday and Andersen’s Social Behaviour Model, was conducted between 1998 and 1999 in Chinese Hebei province and Beijing. A total of 864 eligible married women (age 21 to 60 years) were face to face interviewed. Results The percentage of self- reported symptoms of RTIs in urban and rural women was 35. 6 and 46. 8, respectively; the proportion of women with RTIs who utilised health services was 27. 5% and 26. 7%, respectively. Compared to urban women, rural women had less knowledge on RTIs and more traditional beliefs, and were more satisfied with local health services. The results of logistic regression analysis showed that the common factor influencing health service utilisation in women with RTIs was current experience of RTIs. Knowledge about self- medication, perceived social stigma attached to RTIs, prior experience of RTIs, family income and perceived severity of RTIs were also predictors of utilisation of health services in rural women with RTIs. Satisfaction with health providers, information received from health providers, prior experience of RTIs, occupation and medical care coverage were predictors of utilisation of health services in urban women with RTIs. Conclusion The prevalence of RTIs is high, but the rate of seeking health services is low. There is a great need for emphasizing culturally acceptable reproductive health education in different places to improve women’s ability for self- care. Regular medical check- ups for women are also important. It is necessary to improve the quality of health service, complete the reform of health insurance and alleviate women’s social stigma related to RTIs, giving women social and moral support.     

Alcohol, cannabis and cocaine usage in patients with trauma injuries

Sera from 111 patients with trauma injuries, who presented to the Accident and Emergency Unit (A&E), University Hospital of the West Indies, during a 3-month period, were screened for blood alcohol. Urine specimens were analysed for metabolites of cannabis and cocaine. Sixty-two per cent (62%) of patients were positive for at least one substance and 20% for two or more. Positivity rates were as follows: cannabis (46%), alcohol (32%) with 71% of these having blood alcohol levels (BAC) greater than 80 mg per decilitre; cocaine (6%). Substance usage was most prevalent in the third decade of life. The patients who yielded a positive result were significantly younger than those who were negative. There was no significant difference in age or substance usage between the victims of interpersonal violence or road traffic accidents. In the group designated "other accidents", patients were significantly older and had a lower incidence of substance usage than the other two groups. Cannabis was the most prevalent substance in all groups. Fifty per cent (50%) and fifty-five per cent (55%) of victims of road accidents and interpersonal violence, respectively, were positive for cannabis compared with 43% and 27% for alcohol, respectively. There was no significant difference in Hospital Stay or Injury Severity Score between substance users and non-users.     

Adult pedestrian and cyclist injuries in Lilongwe,Malawi: a cross-sectional study

BackgroundPedestrian and cyclist injuries are a major concern globally, but especially in low-income countries. Locally conducted research is needed to measure the size of the problem and advise policy on road safety interventions. We wanted to investigate the precise circumstances of these injuries in Lilongwe, Malawi and to identify risk factors for severe injuries.MethodsCross-sectional study of all adult pedestrian and cyclist injuries presenting to a large central hospital. This was a sub-study of a larger study with all types of road users included. All patients provided detailed information about the incidents leading to injury and were tested for alcohol.ResultsThere were 222 pedestrians, 183 bicycle riders and 42 bicycle passengers among the 1259 adult road traffic injury victims that were treated at Kamuzu Central Hospital during a 90-day period in 2019. Of these injuries, 60.2% occurred while the victim was walking/cycling along the road and 22.3% when the victim was trying to cross the road. The majority of the victims were men (89.1%). Helmet use for bicyclists was almost non-existent. Only 1 patient had used reflective devices when injured in the dark, despite 44.7% of these injuries occurring in reduced light conditions. There was an increased risk for serious and fatal injuries for pedestrians compared with bicyclists, and also compared with all types of road users. Patients injured in rural areas and those hit by lorries were more severely injured. Consuming alcohol before being injured was associated with more severe injuries in bicyclists. Being injured while crossing the road at painted zebra crossings was associated with an increased risk of serious and potentially fatal injuries.ConclusionThis study identified important risk factors for severe injuries in pedestrians and cyclists. Implications for preventive measures are presented in a Haddon Matrix.     

Pattern of injury in fatal road traffic accidents in a rural area of western Maharashtra,India

Background

Fatal road traffic accidents (RTA) are a major cause of concern all over the world. The outcome of injuries sustained in an RTA depends on various factors including but not limited to: the location of the event, type of vehicle involved, nature of the roads, the time of accident, etc.

Aims

This study aims to investigate and evaluate prospectively the socio-demographic profile and pattern of injuries in victims of RTA in the rural area of the Ahmedanagar district of Maharashtra state.

Method

This prospective study included all victims of RTA that presented to our emergency room from 1 June 2007 to 31 May 2009 and were either found dead on arrival or died during treatment. All the victims were autopsied at the post-mortem centre of Rural Medical College, Loni.

Results

Ninety-eight RTA victims were studied during the period. The most commonly affected age group was 20-39 years. Men died in RTA more than women. Fatal RTA were more prevalent on the secondary road system (47.97 per cent) and especially involved pedestrian and two wheeler vehicle users. Large numbers (n=63, 64.28%) of victims either died on the scene or during transportation. Numbers of skeletal injuries (199) and internal organ injuries (202) exceeded the total number of victims (98) clearly indicating the multiplicity of injuries. The majority of RTA victims (n=46, 46.93%) died due to head injury. The study showed that most deaths in RTA, brought to a tertiary care rural hospital, took place either on the spot or within 24 hours of injury which is very alarming and highlights the need to take urgent steps to establish good pre-hospital care and provision of trauma services at site.

Conclusion

A computerised trauma registry is urgently needed to highlight risk factors, circumstances and chains of events leading to accidents. This would be extremely helpful in policy making and health management in India.     

2000～2006年重庆地区老年人道路交通伤害特点

目的 研究重庆地区60岁以上老年人交通伤害的流行病特征,分析该人群交通事故伤害相关因素.方法 收集重庆市选定地区2000～2006年各交警支队交通事故档案,获取老年人交通伤害数据,用描述流行病学分析该人群交通伤害特征.结果 2000～2006年重庆市抽样地区共发生1 916起老年人伤亡事故,2 025位受害者,年均死亡...     

152例道路交通事故致儿童眼损伤的法医学分析

目的:探讨道路交通事故致儿童眼损伤的类型、损伤特点、主要并发症及其伤残等级分布的特点,为此类案件的法医临床学鉴定提供参考。方法:对152例道路交通事故致儿童眼损伤的伤残评定资料按伤者受伤的临床诊断分类、有无并发症、并发症的类型及伤残程度进行统计分析。结果:1~3岁的儿童因交通事故致眼外伤构成比较低,4~6岁明显上升,11~14岁最高。大部分眼外伤为单眼损伤,眼部钝挫伤129眼,眼球穿通伤21眼,混合型眼部伤20眼,眼部烧伤2眼。主要并发症及后遗症为外伤性白内障53眼(30.8%)、外伤性青光眼18眼(10.5%)、外伤性视网膜脱离14眼(8.1%)、外伤性眼内炎9眼(5.2%)。结论:眼部钝挫伤在道路交通事故致儿童眼损伤中多见,并发症多预后差,鉴定难度较成人增大。针对学龄前和学龄期儿童因道路交通事故致眼损伤的伤残评定应适当放宽标准,伤残评定标准应增加专门针对儿童的条款。     

意外伤害外因及社会预防探讨

这次调查的目的在于分析重庆币九龙坡区意外伤害的外因及分布情况。选用该区1990～1997年意外伤害住院患者出院登记资料,按ICD9编码进行分类统计。结果显示：在各类疾病中,意外伤害约占10．6％。意外伤害主要外因依次为：意外跌伤、交通事故、他杀、机器事故、自杀、坠物砸伤和意外中毒。交通事故伤主要为乡村男性（占40．8％）。意外跌伤、坠物砸伤和机器事故伤主要为城镇男性。他杀和意外中毒主要为乡村青年男性。自杀主要为乡村青年女性（占50．9％）。因此,加强安全教育,完善安全措施,势在必行。     

昆明地区交通事故院前急救干预分析

目的:通过对交通事故现场死亡发生特点及影响因素分析,为交通事故院前急救干预策略提供科学依据。方法:根据昆明医学院司法鉴定中心2004年昆明地区道路交通事故死亡366例法医病理鉴定资料,对交通事故死亡者进行影响因素的单因素与非条件Logistic回归分析。结果:366例中现场死亡202例(55.19%),影响现场死亡的危险因素的相关危险度OR值分别为脊柱骨折(7.56)、骨盆骨折(6.04)、头颈部软组织损伤(4.78)、面骨骨折(2.87)、颅骨骨折(2.64)。结论:脊柱损伤及其复合伤是昆明地区道路交通事故现场死亡最大危险因素之一,对急救人员进行脊柱及其复合伤的专业培训可能是该地区现场死亡有效干预措施之一。