喉外伤56例急救护理体会

目的 探讨喉外伤患者的急救与护理措施。方法 分析2000-2005年收治的56例喉外伤患者，针对喉外伤发生的原因、症状、体征、采取紧急处理出血、休克、呼吸困难等，并给予保持呼吸道通畅、严密观察生命体征、维持血压、加强各种管道、伤口的管理，心理护理等。结果 取得了很好的护理效果。结论 喉外伤虽然来势凶猛，病情危急，但只要给予恰当的急救和护理，就能挽救患者的生命，减少后遗症，提高抢救的成功率。     

骨牵引治疗小儿下肢皮肤撕脱伤伴长骨干骨折(附31例报告)

目的 探讨小儿下肢皮肤撕脱伤伴长骨干骨折采用骨牵引治疗的方法对其预后的影响。方法 对31例本病患儿进行回顾性分析。男20例，女11例，年龄2岁6个月至9岁8个月。受伤肢体：单侧24例，双侧7例。骨折部位：股骨干20处，胫腓骨干20处，胫骨干3处，肢体皮肤撕脱伤面积为120cm^2～546cm^2，平均面积为256cm^2。治疗主要采用多种骨牵引和撕脱皮肤修整呈网眼原位缝合。结果 获随访29例，随访1～5年，疗效满意。结论 下肢多种骨牵引术对治疗本病是一种简单有效的方法。     

Radiographic diagnosis of rotator cuff tear based on the supraspinatus muscle radiodensity

Objective. To evaluate the supraspinatus muscle radiodensity on the outlet view as an indication of a tendon tear. Design and patients. Plain radiographs and magnetic resonance imaging (MRI) examinations were obtained on both shoulders of 40 subjects aged 23–70 years, including 13 asymptomatic volunteers and 27 patients. Two readers analyzed the superior contour and the heterogeneity of the supraspinatus muscle radiodensity and compared them with the MRI findings. Results and conclusion. Significant concordances (P<0.001) were found between the assessments of the superior contour and the heterogeneity of the muscle radiodensity, respectively, on plain radiographs and MR images. For the diagnosis of a full-thickness tear, the analysis of the superior contour and the heterogeneity of the muscle radiodensity reached an accuracy of 85% and 80% respectively. Stepwise discriminant analyses showed low to moderate benefit of considering the contour and the heterogeneity simultaneously. The inter- and intraobserver agreement ranged from moderate to good. We conclude that on the outlet view, modifications in the superior contour and heterogeneity of the supraspinatus muscle radiodensity suggest a full-thickness tear. Received: 6 December 1999 Revision requested: 6 March 2000 Revision received: 5 June 2000 Accepted: 4 October 2000     

Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological–pathological correlation

We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented.     

Speed and spinal injuries

Road traffic accidents (RTA) are a significant cause of spinal trauma. On the 31st of October 2002 a new penalty system for speed related driving offences was introduced in Ireland. Our intention was to assess the effects of the introduction of this system on the activity of the National Spinal Injuries Centre (NSIC) with a retrospective review of all admissions from November 1998 until October 2003. The number of new acute admissions to the spinal injury unit during the study period was 831. In the first 6 months of the new system the number of RTA related admissions fell significantly to 17 compared to an average of 33 in the preceding 4 years. However, this effect was not maintained in the second 6 months. The fall in spinal injuries following RTA in the first 6 months of the new system parallels the pattern of road death reduction in this period. This suggests that driving behaviour can be modified with direct benefits in reducing spinal injuries. However, this effect has not persisted in the second 6 months of the new system suggesting that to maintain this change the perception and familiarity of a penalty are important factors in its impact.     

Injuries among children in Karachi, Pakistan--what, where and how

OBJECTIVES: To describe the epidemiology of injuries among children in Karachi, Pakistan. STUDY DESIGN: Retrospective case series.METHODS: Data on children aged < or =15 years who were injured between October 1993 and January 1996 were extracted from the logs of the main provider of emergency medical transportation, and were classified according to the World Health Organization's basic data set for information on injuries. RESULTS: We identified 1320 cases of injuries in children < or =15 years old. The major causes were: motor vehicle crashes (MVC) (80%), falls other than from vehicles (5%), burns (5%) and drowning (3%). One in six of these children (15%) died either at the scene of the accident or during transportation to the hospital. The majority of deaths were either due to MVCs (67%) or drowning (18%) Large vehicles (buses, minibuses and trucks) were involved in 54% of all childhood road traffic injuries. Almost one-third (33%) of burns took place in the kitchen at home, and half (51%) of all drowning cases occurred in the sea. CONCLUSIONS: The majority of children transported by the ambulance service were male and were victims of MVCs. Prevention efforts aimed at stricter enforcement of driving laws and family/child education geared towards pedestrian safety could potentially reduce morbidity and mortality. This study also highlights the role of the prehospital transport system in injury surveillance.     

The assessment of ocular injury by ultrasound

Ocular trauma is readily investigated by ultrasound, which is of particular value when the light conducting media are opacified by haemorrhage or other injury. In this situation, direct visualization of the ocular contents by ophthalmoscopy is difficult or impossible. Severe complications are treated by microsurgical techniques, and ultrasound evaluation represents the only practicable method of examination for surgical planning. This review illustrates the grey-scale (B scan or two-dimensional) features of the traumatized eye and describes the examination technique.     

Is obesity associated with injuries among young people?

Objectives: To look at the relationship between obesity and trauma among young people in the Hainaut Province in Belgium. Design: A cross-sectional study (questionnaire and physical examination) was conduced among a sample of 2363 children of 9- to 17-year-olds (n = 2363) in 1998. Results: In the past 12 months prior to the survey, 37% of the sample had at least one injury requiring treatment (with or without hospitalization), and 5% had a severe injury (with at least one night at the hospital). More than 15% were classified to be obese according to the WHO definition. We observed a significantly higher frequency of injury in obese people, in boys, in subjects playing sport intensively, with members of a sports club and in those reporting more than one physical activity per week. In multivariate analysis for injury, gender, physical activity, playing sport in a club and obesity were significant. For severe injuries, only gender and physical activity remained significant in the multivariate analysis. Conclusion: Our analysis shows that childhood obesity and physical activity increase the occurrence of injuries. However, we did not observe an association between obesity and severe injuries. Obesity as a risk factor for the occurrence of injuries has to be confirmed by other studies, and the understanding of the mechanism for the observed association needs more investigation.     

中国18省市中学生伤害现状及危险因素分析

目的了解中国青少年伤害的流行状况,为进一步制定相关预防和控制措施提供依据。方法全国18省市中学生共170 602名进行《中国青少年健康相关行为调查问卷》自填。结果中学生伤害的发生率为43.7%,其中二次及以上伤害的报告率为20.9%。男生伤害报告率高于女生,主要差别是由于二次及以上伤害发生引起。该人群中随着年龄的增加,伤害报告率下降,特别是二次及以上伤害报告率。因跌倒和物体砸碰受伤是男女生最常见的受伤原因,割刺伤和骨关节伤是男女生最常见的受伤结果。重点中学、核心家庭和母亲高学历是各类伤害及再发伤害的保护性因素。结论中学生伤害发生率高,应针对原因采取有效措施,减少伤害特别是二次伤害的发生。