Murphy R X, Birmingham K L, Okunski W J, Wasser T
Department of Surgery, Lehigh Valley Hospital, Allentown, PA, USA.
Plast Reconstr Surg. 2000 Feb;105(2):516-20. doi: 10.1097/00006534-200002000-00005.
According to the National Highway Traffic Safety Administration (1990), there were more than 3 million motor vehicle collisions severe enough to lead to significant injury or fatality. Airbags may prevent brain and facial injury caused by these accidents. To date, however, no study has focused primarily on the correlation between facial injuries and the use of airbags and restraining devices. A retrospective analysis was performed on motor vehicle collision data submitted to the Pennsylvania Trauma Outcome Study database from 1990 through 1995. Criteria for submission to the database included admission to the intensive care unit, death during hospitalization, hospitalization for >72 hours, or transfer to or from the receiving hospital. There were 15,450 patients who sustained facial trauma (identified by ICD-9 codes) and were analyzed for patterns of injury and the presence or absence of protective devices. Protective devices were categorized into four groups: airbag alone, airbag with seatbelt, seatbelt or car seat without airbag, and no restraining devices. Statistical analysis was performed using chi-squared test of association. For contingency tables with small expected frequencies, Fisher's exact test was used. There were 9408 male and 6042 female subjects, with a mean age of 38 years (range, 3 to 98 years). There were 11,672 drivers and 3778 passengers. Airbags were deployed in 429 instances. In 276 of these cases, additional restraint was provided with a seatbelt. Airbags were not deployed in 4866 cases when a seatbelt or a car seat was used. In 10,155 cases, no restraining device was employed. There was significantly more facial trauma in patients without protective devices (p < 0.001). Drivers sustained significantly fewer facial fractures when airbags were used, either alone or in combination with a seatbelt (p < 0.001); however, there was no difference in the number of facial lacerations. Among passengers, airbags provided protection from lacerations (p < 0.001) but had no impact on the incidence of facial fractures. In collisions in which airbags were deployed, the use of a seatbelt provided no additional protection from facial fractures or lacerations. In summary, the use of any protective device decreased the incidence of facial fractures and lacerations sustained in motor vehicle collisions (p < 0.001). Airbags provided the best protection of all currently available devices.
根据美国国家公路交通安全管理局（1990年）的数据，有超过300万起机动车碰撞事故严重到足以导致重伤或死亡。安全气囊可能会预防这些事故造成的脑部和面部损伤。然而，迄今为止，尚无研究主要关注面部损伤与安全气囊及约束装置使用之间的相关性。对1990年至1995年提交至宾夕法尼亚创伤结局研究数据库的机动车碰撞数据进行了回顾性分析。提交至该数据库的标准包括入住重症监护病房、住院期间死亡、住院超过72小时，或转至接收医院或从接收医院转出。共有15450名面部受创患者（通过国际疾病分类第九版编码识别），对其损伤模式以及是否存在保护装置进行了分析。保护装置分为四组：单独使用安全气囊、安全气囊与安全带并用、使用安全带或汽车座椅但无安全气囊、未使用约束装置。使用卡方关联检验进行统计分析。对于预期频数较小的列联表，使用费舍尔精确检验。共有9408名男性和6042名女性受试者，平均年龄为38岁（范围为3至98岁）。其中有11672名驾驶员和3778名乘客。安全气囊展开了429次。在这些案例中，有276例同时使用了安全带作为额外约束。在使用安全带或汽车座椅的4866例案例中，安全气囊未展开。在10155例案例中，未使用任何约束装置。未使用保护装置的患者面部创伤明显更多（p < 0.001）。单独使用安全气囊或与安全带并用时，驾驶员面部骨折明显较少（p < 0.001）；然而，面部裂伤的数量没有差异。在乘客中，安全气囊可防止裂伤（p < 0.001），但对面部骨折的发生率没有影响。在安全气囊展开的碰撞事故中，使用安全带并不能额外预防面部骨折或裂伤。总之，使用任何保护装置均可降低机动车碰撞中面部骨折和裂伤的发生率（p < 0.001）。在所有现有装置中，安全气囊提供的保护最佳。
