浙江省0～14岁儿童伤害急诊监测结果分析

目的 了解浙江省儿童伤害发生特点及规律,为制定相应的预防控制策略提供科学依据.方法 监测2005年1月至12月首次在哨点医院(2005年浙江省医院伤害急诊监测系统有5个监测点:金华市、嵊泗县、桐乡市、宁波市鄞州区、海宁市,每个监测点设立3家哨点医院:一家县级医院、一家乡镇中心卫生院、一家乡镇卫生院,开展伤害监测工作)急诊就诊,被诊断为伤害的儿童,由经过培训的急诊室医生或护士填写统一的监测表.内容包括儿童伤害的一般情况、伤害发生的时间、地点、伤害性质等.调查在患儿神志清醒的状态下进行,调查内容要保密,当患儿不能自己回答时,可询问知道相应情况的家人或陪同者.统计学方法 采用均数和构成比描述各项因素,包括性别、年龄、伤害发生时间、发生地点、发生原因、伤害严重程度等,采用y2检验考察构成是否存在差异.结果 2005年共监测到儿童伤害病例1794例,其中男性67.56%,女性32.44%;以本地居民为主,年龄(7.33±3.84)岁;最多的伤害发生地点是家中;4～11月为伤害的高发季节;伤害原因占前3位的分别是跌伤(47.94%)、交通伤(17.17%)和钝器伤(10.26%);儿童伤害发生时的活动第一位都是空闲时(67.66%),其次是学校活动(11.25%)和运动时(9.96%);90.33%的伤害患者经处理后回家,1.40%留观,7.04%住院,0.56%转院治疗,0.22%死亡,0.45%不详;以轻微浅表伤和中等程度伤害为主;儿童伤害最常见的3种性质是血肿瘀伤(31.29%)、浅表擦伤(23.69%)和骨折(8.67%);受伤部位按大类分,头部占39.47%,上肢25.80%,下肢28.55%,躯干4.81%,其他1.38%.结论 浙江省内儿童伤害最常见的是血肿瘀伤、浅表擦伤和骨折,伤害原因主要是跌伤、交通伤和钝器伤.儿童伤害常发生在空闲时,学校活动和运动时,因此,应加强安全教育和安全保护.     

2016-2019年荆门市60岁及以上老年人伤害病例分析

目的 对2016-2019年荆门市老年人伤害发生基本情况进行分析,为制定老年人伤害预防控制策略提供参考.方法 收集2016-2019年荆门市3家伤害监测哨点医院的首次就诊60岁及以上伤害患者报告卡信息,分析60岁及以上老年人伤害病例分布特征.结果 2016-2019年3家哨点医院共登记60岁及以上老年人伤害病例6271...     

2015年天津市14岁以下儿童伤害监测分析

目的 了解天津市0~14岁儿童伤害发生的现状,为制定相关干预政策和开展儿童安全教育提供依据。方法 数据源自天津市发病报告监测体系中2015年首次因伤害就诊于各级医疗机构的病例资料。结果 2015年天津市共报告0~14岁儿童伤害33 751例,发生率为2 624.62/10万,男女性别比为1.78:1,城乡比为1.33:1。伤害原因前5位的是跌倒（13 971例,占41.39%）、动物致伤（8 562例,占25.37%）、交通伤害（2 715例,占8.04%）、砸伤（1 479例,占4.38%）和利器割伤（1 432例,占4.24%）。轻、中、重度和死亡依次为24 947例（73.91%）、7 520例（22.28%）、1 196例（3.54%）和88例（0.26%）,差异有统计学意义（2=50.22,P0.001）,且不同年龄组间差异均有统计学意义（P0.001）。男童和城市儿童是预防伤害发生的重点人群;而死亡分析中,男童和农村儿童是干预的重点人群。结论 应根据儿童不同年龄段、不同性别特征有针对性、有重点的进行干预,减少儿童伤害的发生。     

2013年济南市伤害监测病例特征分析

目的 分析济南市2013年伤害监测病例流行病学特征,为针对性干预提供技术依据。方法 通过山东省伤害监测系统,收集2013年度哨点监测医院住院的伤害病例(含急诊观察病例)。结果 2013年共报告伤害病例4021例,男女性别比1.84:1。15~64岁人群占81.20%,其次为65岁以上老年人12.66%。农林牧渔水利业生产人员、生产运输设备操作人员、学生分别占73.36%、8.73%和4.77%。08:00-11:00和15:00-17:00共报告2093例,占53.42%。公路街道、住宅、工业或建设场所为伤害发生地点前3位,分别占39.59%、30.96%和13.16%;钝器伤、刺伤/锐器伤、身体用力过度居伤害前3位,分别占73.39%、8.16%和5.99%。伤害部位前3位的是头面部、上肢、下肢,分别占30.99%、22.23%和21.84%。结论 2013年济南市伤害监测病例男性多于女性,主要伤害原因为钝器伤、意外事故、非故意伤害为主,伤害部位以头面部和四肢为主,骨折与浅表损伤居前列。     

2011年江苏省张家港市伤害监测病例分布特征分析

目的 了解2011年江苏省张家港市伤害监测病例分布特征,为制定伤害预防控制策略提供依据。 方法 收集张家港市3家伤害监测哨点医院2011年填报的全国伤害监测报告卡资料,按照世界卫生组织伤害监测指南分类标准进行归类和统计分析。 结果 2011年共收集伤害病例28 807例,男女性别比为1.6:1,其中25~44岁组病例数所占比例最高(37.62%);伤害发生原因前3位依次为道路交通伤害(22.53%)、跌倒/坠落(22.21%)和钝器伤(18.67%);伤害发生地点主要为工业建筑场所(29.65%)、公路/街道(27.79%)和家中(25.29%);伤害病例以非故意伤害(94.95%)和轻度伤害(71.55%)为主。 结论 医院伤害监测是获得伤害信息的重要来源,对确定伤害干预重点、有针对性地运用预防干预措施减少伤害的发生有积极作用,同时应针对道路交通伤害、跌倒/坠落和钝器伤等伤害积极开展预防控制工作。     

5833例0～6岁儿童微量元素检测结果分析

目的了解重庆市沙坪坝地区0~6岁儿童钙、镁、锌、铁以及铜5种微量元素水平,为儿童科学合理补充微量元素和临床药物治疗提供依据。方法 2013年1~12月按自愿随机原则,选择沙坪坝区其中的5个街镇0~6岁的儿童5 833例,采用原子吸收光谱法进行钙、镁、锌、铁以及铜的检测,用Excel软件按小于1岁、1岁、2岁、3岁、≥4岁5个年龄组进行资料收集、整理和统计分析。结果沙坪坝地区0~6岁儿童钙、镁、锌、铁以及铜的缺乏率分别为16.96%、1.92%、47.57%、43.56%、11.47%。各年龄组儿童的钙、锌、铁、铜的缺乏率差异均有统计学意义(P0.01),≥4岁年龄组钙的缺乏率最高,1岁年龄组锌、铁的缺乏率最高,铜的缺乏率有波动。各年龄男女儿童钙、镁、锌和铁缺乏率差异无统计学意义(P0.05),各年龄组男女儿童铜的缺乏率差异有统计学意义(P0.05),女童铜的缺乏率高于男童。结论沙坪坝地区儿童锌、铁的缺乏较普遍,其次是钙、铜、镁的缺乏少见。婴幼儿提倡母乳喂养,及时添加辅食,幼儿和学龄前儿童合理饮食搭配,定期进行微量元素的检测,必要时在医生的指导下,合理补充微量元素。同时规范实验室检测人员的操作,提高检测结果的准确性,为临床提供可靠的依据。     

南京城区及周边农村地区儿童意外伤害的调查与分析

目的了解南京城区及周边农村地区儿童意外伤害的情况。方法对2007年1月至2009年12月某医科大学附属儿童医院收治的意外伤害儿童2551例进行问卷调查,调查意外伤害儿童的性别、年龄、伤害发生的原因以及治疗结果等。结果南京城区及周边农村地区儿童意外伤害的类型按照人数进行排序,前3位依次为：跌倒/跌落、气管异物及烧/灼/烫伤;1～3岁是儿童意外伤害发生的高峰;发生意外伤害的2551例儿童中,南京周边农村地区儿童1618例（占63.4%）,南京城区儿童933例（占36.6%）,农村地区意外伤害的儿童数多于城区。结论应对儿童及其家长进行针对性的育儿安全宣传教育,使家长了解不同年龄、不同季节儿童发生意外伤害的特点及预防应对方法,避免儿童意外伤害的发生。     

Soccer Injuries in Children Requiring Trauma Center Admission

Background

Soccer continues to gain popularity among youth athletes, and increased numbers of children playing soccer can be expected to result in increased injuries.

Objective

We reviewed children with soccer injuries severe enough to require trauma activation at our Level I trauma center to determine injury patterns and outcome. Our goal is to raise awareness of the potential for injury in youth soccer.

Methods

A retrospective review was performed using the trauma registry and electronic medical records at a Level I trauma center to identify children (< 18 years old) treated for soccer injury from 1999–2009. Data reviewed include age, gender, mechanism, injury, procedures, and outcome.

Results

Eighty-one children treated for soccer injury were identified; 38 (47%) were male. Of these, 20 had injury severe enough to require trauma team activation and 61 had minor injury. Mean age was 14 years old (range 5–17 years, SD 2.3). Lower extremity was the most common site of injury (57%), followed by upper extremity (17%), head (16%), and torso (10%). Mechanisms were: kicked or kneed in 27 patients (33%), collision with another player in 25 (31%), fall in 18 (22%), struck by ball in 10 (12%), and unknown in 1 (1%). Procedures included reduction of fractures, splenectomy, abdominal abscess drainage, and surgical feeding access. Long hospitalizations were recorded in some cases. There were no deaths.

Conclusion

Although less common, injury requiring prolonged hospital admission and invasive operative procedures exist in the expanding world of youth soccer. With increasing participation in the sport, we anticipate greater numbers of these child athletes presenting with serious injury.     

北京市0～6岁智力低下儿童父母对残疾康复认识情况分析

目的了解智力低下儿童康复状况及其父母对康复相关知识的认识情况。方法采用问卷调查方式对2004年在残疾人抽样调查中诊断的237名智力低下儿童进行现场或入户回访。结果 2004年诊断智力低下的儿童在3年中接受康复治疗服务比例为25.99%,农村未康复者明显高于城市（χ2=18.67,P〈0.01）;父母知道儿童需要进行早期干预康复及家庭训练的比例分别为38.39%、16.52%。结论需加强对其养育人的健康教育和知识技能培训。     

Sports-related Injuries in Children

OBJECTIVE: To describe the demographics and types of sports-related injuries (SRIs) in children. METHODS: The authors performed a retrospective chart review of children 5-18 years of age diagnosed as having an SRI in a pediatric emergency department (ED) during a two-year period. Patients were identified by ICD-9 codes. Data collected were age, sex, sport, ED interventions, consultations, mechanism, location, and injury type. Pairwise comparisons were reported as odds ratios with 95% confidence intervals. RESULTS: Six hundred seventy-seven SRIs fit the inclusion criteria; 480 of the patients were male (71%). The mean ages of the males and females were 13.0 years (SD +/- 3.0 yr) and 12.4 years (SD +/- 2.9 yr), respectively. The six most common sports implicated were basketball (19.5%), football (17.1%), baseball/softball (14.9%), soccer (14.2%), in-line skating (Rollerblading)/skating (5.7%), and hockey (4.6%). Sprains/strains (32.0%), fractures (29.4%), contusions/abrasions (19. 3%), and lacerations (9.7%) accounted for 90% of injury types. Pairwise comparison of the four injury types in the six sports listed showed significant associations for contusions/abrasions in baseball, sprains/strains in basketball, fractures in Rollerblading/skating, and lacerations in hockey. Age variance, including all sports, of the younger group (5-11 yr) in fractures and the older group (12-18 yr) in sprains was significant. The most common injury location was wrist/hand (28%), followed by head/face (22%) and ankle/foot (18%). Each had significant sport-specific predilections. Contact with person or object was the mechanism for >50% of the SRIs. Sport-specific mechanisms followed lines drawn from the sport-specific injury types and locations. CONCLUSIONS: The pediatric age group incurs a variety of injuries in numerous sports with diverse sex, age, mechanism, location, injury type, and sport-specific differences.     

农村事故倾性儿童意外伤害的流行病学特征

目的分析农村事故倾性儿童意外伤害的流行病学特征,以期为农村事故倾性儿童的意外伤害防控提供参考依据。方法采用随机整群分层抽样法抽取湖南省某农村地区1601名儿童,采用自制的《伤害调查表》对其进行问卷调查,以筛出的事故倾性儿童作为研究对象,分析其意外伤害的特征。结果本研究共筛出事故倾性儿童147名,发生率为9.4%;跌落伤居事故倾性儿童意外伤害发生类型的首位(22.7%),发生时间以10月份最高,其次为7、8月份,地点主要在家中(40.5%)和学校(24.1%)。结论农村地区儿童事故倾性的发生率处于较高水平,应根据事故倾性儿童意外伤害的特征采取一定的预防干预措施,以降低其发生率,维护儿童安全。     

Identification of Intra-abdominal Injuries in Children Hospitalized Following Blunt Torso Trauma

OBJECTIVE: To determine the utility of the ED physical examination and laboratory analysis in screening hospitalized pediatric blunt trauma patients for intra-abdominal injuries (IAIs). METHODS: The authors reviewed the records of all patients aged <15 years who sustained blunt traumatic injury and were admitted to a Level 1 trauma center over a four-year period. Patients were considered high-risk for IAI if they had any of the following at ED presentation: decreased level of consciousness (GCS < 15), abdominal pain, tenderness on abdominal examination, or gross hematuria. Patients without any of these findings were considered moderate risk for LAI. The authors compared moderate-risk patients with and without IAIs with regard to physical examination and laboratory findings obtained in the ED. RESULTS: Of 1,040 children with blunt trauma, 559 (54%) were high-risk and 481 (46%) were moderate-risk for IAI. 126 (23%) of the high-risk and 22 (4.6%) of the moderate-risk patients had IAIs. Among moderate-risk patients with and without IAIs, those with IAIs were more likely to have abdominal abrasions (5/22 vs 34/459, p = 0.008), an abnormal chest examination (11/22 vs 86/457, p = 0.01), higher mean serum concentrations of aspartate aminotransferase (AST) (604 U/L vs 77 U/L, p < 0.001) and alanine aminotransferase (ALT) (276 U/L vs 39 U/L, p = 0.002), higher mean white blood cell (WBC) counts (16.3 K/mm3 vs 12.8 K/mm3, p < 0.001), and a higher prevalence of >5 RBCs/hpf on urinalysis (7/22 vs 54/427, p = 0.02). There was no significant difference (p > 0.05) between moderate-risk patients with and without IAIs in initial serum concentrations of amylase, initial hematocrit, drop in hematocrit >5 percentage points in the ED, or initial serum bicarbonate concentrations. CONCLUSION: In children hospitalized for blunt torso trauma who are at moderate risk for IAI, ED findings of abdominal abrasions, an abnormal chest examination, and microscopic hematuria as well as elevated levels of AST and ALT, and elevated WBC count are associated with IAI.     

2015-2018年深圳市南山区老年伤害医院监测患者特征分析

目的 分析2015-2018年深圳市南山区老年人伤害监测病例分布及特征,为预防控制老年伤害发生提供依据.方法 通过伤害监测系统收集2015-2018年间因伤害首次在深圳市南山区伤害监测哨点医院急诊室就诊的60岁及以上老年病例资料,并进行描述性分析.结果 共收集老年伤害病例10 616例,男女性别比为1∶1.35;伤害发...     

Childhood Soccer Injuries Treated in U.S. Emergency Departments

Objectives: Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury‐related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer‐related injuries and described the nature of these injuries. Methods: Data from the 2000 National Electronic Injury Surveillance System All Injury Program were used to estimate the overall number and rate of soccer injuries in children, calculate injury rates per 1,000 children, and describe the body regions affected and types of injuries. Results were stratified by five‐year age groups (5–9 years, 10–14 years, and 15–19 years). Results: Approximately 144,600 children sustained soccer‐related injuries in 2000 for a rate of 2.36 injuries per 1,000 children. Injury rates increased with age (0.8, 5–9 year olds; 3.1, 10–14 year olds; 3.2, 15–19 year olds). Common types of injuries were strains/sprains (36.7%), fractures (23.0%), and contusions (20.9%). Fractures decreased with age; sprains/strains increased with age. Commonly injured body regions varied by age. Wrist and finger injuries were most common (12.7% and 12.4%, respectively) in the youngest group; in the 10–14‐year‐old group, ankle and wrist injuries were most common (15.7% and 13.6%, respectively). In the oldest age group, ankle injuries were most common (21.9%), followed by knee injuries (17.6%). Conclusions: Substantial numbers of children were treated in EDs for soccer‐related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer‐related injuries may need to be age specific.     

Work-related Injuries in a Rural Emergency Department Population

Objective: To describe the spectrum of work-related injury evaluated in a rural ED population. Methods: An ED-based injury surveillance system (EDBISS) was used to collect injury data for all ED patients seen over a 1-year period. A patient was classified as injured if his or her record contained an ED log injury code, an ICD-9 N-code between 800 and 995 in any diagnostic field, an E-code, or an entry in the trauma registry. An injury was considered work-related if the patient reported that the injury had occurred while at work. Results: Work-related injuries accounted for 1,539/12,321 (12.5%) of all injuries. The mean age of patients injured on the job was 33.8 years (range, 16–77 years), compared with a mean age of 27.7 years for all the injured patients. Males accounted for 1,026/1,537 (67%) of the work-related injury visits, compared with 57% of all the injury visits. The most common mechanisms of work-related injuries were: overexertion (313; 20%); cut or pierced by sharp implements (248; 16%); falls (250; 16%); struck by object (202; 13%); and transportation-related injuries (71; 5%). Sprains and strains were the most common type of injury sustained (415; 27%), followed by wounds to upper limbs (283; 18%), contusions (182; 12%), and fractures (151; 10%). Of the 1,539 patients presenting with occupational injuries, 178 (12%) presented to the ED via ambulance. Most (1,401; 91%) were treated and released from the ED, with the remainder (136; 9%) hospitalized. The mechanisms of injury that most commonly resulted in hospitalization included struck by an object (28; 21%), transportation (26; 19%), falls (27; 20%), crushing mechanism (13; 10%), and machinery (20; 15%). Of those requiring hospitalization, 132/136 (97)% were male, and the average length of stay was 4.4 days. Four of the hospitalized persons died of their work-related injuries. Known medical charges incurred by patients injured at work were as high as $62,622. The average charge for those treated and released was $273; the average charge for those who required hospitalization was $10,910. Conclusions: Occupational injuries contribute significantly to the overall incidence of injuries seen in this ED and are responsible for significant medical charges each year.     

成都市786例0～6岁儿童全血微量元素检测结果分析

目的了解成都地区0~6岁儿童微量元素的含量及在不同年龄段的变化情况。方法采用BH5100T型原子吸收光谱仪对四川省人民医院2015年4~11月786例0~6岁体检儿童微量元素Cu、Zn、Ca、Mg、Fe进行检测,对检测结果进行统计学分析。结果成都地区体检儿童微量元素Cu、Zn、Ca、Mg、Fe的缺乏率分别为0.4%、5.0%、18.1%、9.5%、8.3%,其中1岁、1岁、2岁、3岁和≥4岁儿童Ca的缺乏率分别为47.4%、27.5%、12.6%、9.9%、11.9%,可见1岁儿童Ca的缺乏率较高。各年龄组中Ca的缺乏率比较差异有统计学意义(P0.05),各年龄组男女儿童几种微量元素的缺乏率均无性别差异。结论成都地区0~6岁体检儿童微量元素异常率较高,其中Ca的缺乏率最高,同时Mg和Fe也较为缺乏。儿童微量元素含量与喂养习惯有密切关系,该地区的0~6岁儿童应注意微量元素的补充,尤其是Ca的补充,同时提倡母乳喂养。