深圳市龙岗区2005—2010年职业病危害事故分析

目的分析深圳市龙岗区2005—2010年职业病危害事故,为预防职业病危害事故的发生提供对策依据。方法对6年间职业病危害事故资料进行综合分析,其中行业系统按照《国民经济行业分类和代码》GB/T4754-2002大类划分归类;结果62宗职业病危害事故中,有机溶剂导致事故26宗,占41.94%;金属制品业发生事故14宗,占22.58%。127例职业病病人中,有机溶剂导致职业病65例,占51.18%;电子及通信设备制造业发生职业病39例,占30.71%;结论有机溶剂是该区造成职业病危害事故的主要职业危害因素,电子及通信设备制造业和金属制品业是我区发生职业病危害事故的主要行业。     

交通伤致颈椎挥鞭样损伤的急诊诊治

目的 总结交通伤致颈椎挥鞭样损伤的临床特点,为急诊诊治提供参考.方法 对2002年1月至2008年12月急诊收治的交通伤所致的263例颈椎挥鞭样损伤患者的临床表现、影像学检查结果和急诊早期处理方法进行回顾性分析总结.结果 该损伤临床表现呈多样性,以颈肩枕部疼痛不适和压痛最常见,多数患者伤后数小时内出现症状,但约1/3患者症状迟发;影像学检查中,X线片阳性结果最低,CT和MRI阳性结果高;222例保守治疗和41例手术治疗的患者,经平均7.2个月随访总体治疗效果满意.结论 根据交通事故中驾乘人员易出现颈椎挥鞭样损伤的创伤条件,结合临床表现可以对其进行早期诊断、及时治疗,多数预后较好,综合应用影像学检查町避免漏诊,CT检查可以作为诊断的重要手段.     

Establishment of the model of motorcyclist ejection injury

Objective： To establish the device and model of motorcyclist ejection injury. Methods： Based on our laboratory devices, a motorcyclist ejection injury simulation system was developed. A total of ! 8 pigs were approved by the local animal experi- mentation and ethics committee to serve as the motorcyclist substitutes. In this ejection motion, the animal rode freely at the motor driver seat and was straightly accelerated by means of our custom motorcyclist ejection injury simulation system. When it was speeded up to the preset velocity （v=30, 40 or 50 km/h） at the preset position, the animal was ejected forward. Pathological and dynamic analyses were conducted, accompanied with the high-speed photograph, acceleration/velocity signal test, gross observation and light microscope examination as well as the abbreviated injury score-injury severity score （AIS-ISS） scale. Results： The high-speed photograph indicated that during the ejection procedure the motorcycle was first arrested and decelerated suddenly, and then the motorcycle driver was ejected forward, accompanied with the rotation motion in the air. Finally, the head, shoulder and thorax of the ejected animal impacted directly on the hard ground. Varying degrees of injury focusing on the liver, heart, lung and spleen were found. There existed a significant positive correlation between ISS and the ejection velocity of the motorcycle drivers （ISS=16.7±2.9 for 30 km/h, 25.0±0.0 for 40 km/h and 37.3±1.0 for 50 km/h）. The detailed injury characteristics were as follows： for the mildly injured animals, there were interlobar gaps or leaf gaps and lobar surface blood coagulation blocks in the liver, and mild lung hemorrhage; for the severely injured animals, there were liver comminuted laceration, moderate lung hemorrhage and heart injury. Animals suffering from the most severe injuries died half an hour later. Conclusion： The new injury model stated in this paper has a high stability and good repeatability, and is likely to be helpful to deeply investigate the injury mechanisms and protection countermeasures of motorcyclist ejection injury.     

Neighbourhood variations in child accidents and related child and maternal characteristics: does area definition make a difference?

Accident occurrence and measures of physical activity, total development and conduct difficulties were recorded for 9391 pre-school children recruited to the Avon Longitudinal Study of Parents and Children (ALSPAC) study in southwest England. Information about their mothers' age at delivery, post-natal depression, life events, social support and smoking status was also included. Multilevel modelling was used to identify variations between alternative sets of subjective and automated zone design neighbourhoods, which incorporated different boundaries and different scales. The risk of accidents to pre-school children, and most of the characteristics of children and mothers associated with accident risk, varied significantly between neighbourhoods. Differences in the strength of area effects between alternative sets of neighbourhoods were small, although slightly stronger effects were observed in areas with populations less than 4000. Neighbourhoods subjectively defined by planners did not produce stronger effects than computer-generated areas.     

Traumatic bronchial injury

IntroductionTracheobronchial injury is a recognized, yet uncommon, result of blunt trauma to the thorax. Often the diagnosis and treatment are delayed, resulting in attempted surgical repair months or even years after the injury.Presentation of the caseWe present a case report of a 31-year old female who suffered a left main bronchus transection after a motor vehicle accident. The diagnostic, management issues, and clinical findings surrounding this injury are reviewed.DiscussionTracheobronchial disruption is a rare, life-threatening injury. Suspicion should be high when pneumomediastinum and pneumothorax are refractory to adequate pleural drainage. Flexible bronchoscopy with intubation distal to the injury may be necessary to prevent loss of the airway. Advance preparation should include setups for bronchoscopy, thoracotomy, and cardiopulmonary bypass. Patient survival depends on preparation and prompt surgical intervention.ConclusionA high level of suspicion and the liberal use of bronchoscopy are important in the diagnosis of tracheobronchial injury. A tailored surgical approach is often necessary for definitive repair.     

深圳市1328例道路交通伤流行病学特征及伤情特点分析

目的 通过医院急诊就诊渠道分析深圳市道路交通伤的流行病学特征及伤情特点.方法 预先设计调查问卷,在2007年1月-2007年12月对深圳市6所综合性医院急诊外科收治的道路交通伤患者的临床资料进行分析. 结果 共收集道路交通伤患者1 328例;年龄2～84岁,平均31岁.受伤人群主要为工人和农民工(57.8%);肇事车辆主要为小型汽车(48.5%);道路交通伤发生主要地点为市内公路(78.6%);伤害发生的周分布中,以星期五、六最多,分别达到17.8%和18.7%,在星期五存在集中趋势(r=0.166 0,P<0.01).伤害发生的昼夜分布中,围绕下午15:35存在集中趋势(r=0.285 6,P<0.01);男性年龄(32.36±8.70)岁,大于女性年龄(29.96±4.32)岁,差异有统计学意义(P<0.01).随访患者中84.4%恢复原来工作,8.5%调换工作,7.1%不能参加工作. 结论 可以通过进一步加强工人和农民工交通安全教育,提高交通安全意识.根据道路交通伤的高发时间曲线在道路交通多发时段、地段适当增加交通管理人员,增加交通安全提示标志.控制小型汽车数量是减少交通事故发生的有效手段.     

School accidents in Austria

The aim of this study was to obtain information about the mechanisms and types of injuries in school in Austria. Children between 0 and 18 years of age presenting with injuries at the trauma outpatient in the Department of Pediatric Surgery in Graz and six participating hospitals in Austria were evaluated over a 2-year prospective survey. A total of 28,983 pediatric trauma cases were registered. Personal data, site of the accident, circumstances and mechanisms of accident and the related diagnosis were evaluated. At the Department of Pediatric Surgery in Graz 21,582 questionnaires were completed, out of which 2,148 children had school accidents (10%). The remaining 7,401 questionnaires from peripheral hospitals included 890 school accidents (12%). The male/female ratio was 3:2. In general, sport injuries were a predominant cause of severe trauma (42% severe injuries), compared with other activities in and outside of the school building (26% severe injuries). Injuries during ball-sports contributed to 44% of severe injuries. The upper extremity was most frequently injured (34%), followed by lower extremity (32%), head and neck area (26%) and injuries to thorax and abdomen (8%). Half of all school related injuries occur in children between 10 and 13 years of age. There are typical gender related mechanisms of accident: Boys get frequently injured during soccer, violence, and collisions in and outside of the school building and during craft work. Girls have the highest risk of injuries at ball sports other than soccer.     

1994～2003年全国各类学校食物中毒事件分析

目的 研究近10a来全国学校食物中毒的状况和特点，以便为预防和控制学校食物中毒事件提供依据。方法通过中国期刊网，检索1994～2003年报道的全国学校食物中毒资料，相关内容过录到调查表中，采用SAS8．1软件统计分析。结果10a间共发生学校食物中毒298起，中毒人数23996人。每年中毒人数、中毒次数未见下降趋势。其特点是食物中毒事件多发生在每年的二、三季度。298起食物中毒事件中中学占38，26％，大中专院校占26，51％，小学占23，49％，幼托机构占11，74％；微生物性食物中毒占60．40％、化学性的占23．15％，植物毒素的占13．09％。因加工不当、原料污染、生熟交叉导致的食物中毒分别占40.27％，19.13％和11.41％；65．10%中毒食品来源于学校食堂，来源于个体摊点和批发零售的占18.45％。结论进一步开展卫生法规和食品卫生知识宣传，提高卫生意识．加大监督、监测力度可有效预防学校食物中毒事件的发生。     

严重创伤救治规范的研究与推广

创伤是全球性的社会突出问题，每年全世界死于创伤的人数达580万［1］。建筑工伤和交通伤成为日常创伤的主要原因，目前严重创伤已成为我国青壮年的第一位死亡原因，这不仅由于创伤的持续高发，也与我国创伤救治的整体发展滞后密切相关。