Crankson S J, Fischer J D, Al-Rabeeah A A, Al-Jaddan S A
Department of Surgery, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2001 Feb;22(2):117-20.
A retrospective analysis of the medical records of children up to 12 years of age inclusive, who sustained thoracic injuries during a 6-year period.
Ninety-one children were treated at King Fahad National Guard Hospital, Riyadh from January 1993 through December 1998. The clinical data included age, sex, mechanism of injury, associated injuries, pediatric trauma score, treatment and mortality.
Eighty-seven children (96%) had injuries from blunt trauma and 4 from penetrating injuries. Of the blunt trauma cases, 82 children sustained motor vehicle accident related injuries, 62 as pedestrians and 20 as passengers. Penetrating thoracic injuries occurred in 4 children: 1 stab wound and 3 gunshots. The most frequent thoracic injuries were pulmonary contusion (70), pneumothorax (32), fractured rib (20) and fractured clavicle (18). Extrathoracic injuries included head (45), abdominal (41) and skeletal (26). Thoracotomy was required in only 1 child, laparotomy being necessary in 9 children for intraabdominal injuries. Tube thoracostomy was required in 33 children. Nine children died from motor vehicle accident related fatal head and neck injuries, 8 as pedestrians all with a pediatric trauma score < or = 6.
Thoracic injuries in children below 12 years of age are usually from motor vehicle accident related blunt trauma. Pulmonary contusion and pneumothorax are the most common thoracic injuries. Most thoracic injuries can be managed either conservatively or by tube thoracostomy. Thoracic trauma in children is an indicator of multisystem injury with head injury being the most common cause of mortality.
对6年间12岁及以下儿童胸部损伤的病历进行回顾性分析。
1993年1月至1998年12月期间，利雅得法赫德国民警卫队医院共治疗了91名儿童。临床资料包括年龄、性别、损伤机制、合并伤、儿童创伤评分、治疗及死亡率。
87名儿童（96%）为钝性创伤，4名儿童为穿透性创伤。钝性创伤病例中，82名儿童因机动车事故受伤，其中62名是行人，20名是乘客。4名儿童发生穿透性胸部损伤：1例刺伤，3例枪伤。最常见的胸部损伤为肺挫伤（70例）、气胸（32例）、肋骨骨折（20例）和锁骨骨折（18例）。胸外损伤包括头部（45例）、腹部（41例）和骨骼（26例）。仅1名儿童需要开胸手术，9名儿童因腹部损伤需要剖腹手术。33名儿童需要胸腔闭式引流。9名儿童死于与机动车事故相关的致命头颈部损伤，8名行人死亡，其儿童创伤评分均≤6分。
12岁以下儿童胸部损伤通常由与机动车事故相关的钝性创伤引起。肺挫伤和气胸是最常见的胸部损伤。大多数胸部损伤可采用保守治疗或胸腔闭式引流。儿童胸部创伤是多系统损伤的一个指标，头部损伤是最常见的死亡原因。
