Siegel J H, Loo G, Dischinger P C, Burgess A R, Wang S C, Schneider L W, Grossman D, Rivara F, Mock C, Natarajan G A, Hutchins K D, Bents F D, McCammon L, Leibovich E, Tenenbaum N
Department of Surgery, New Jersey Medical School-UMDNJ, Newark, New Jersey 07103, USA.
J Trauma. 2001 Nov;51(5):975-90. doi: 10.1097/00005373-200111000-00024.
Data using crash dummies suggest that motor vehicle crashes (MVCs) involving passenger sedans (S) vs sport utility, vans, or light trucks (SUVTs) produce more severe injuries than those involving two sedans (SvS). However, no detailed data regarding pattern of injuries or force mechanisms involved have been presented in real patients.
The relationship of injury patterns and severities with MVC reconstruction data were obtained in 412 MVC patients, drivers or front seat passengers. Crashes were examined with regard to impact direction, frontal (F) or lateral (L) crashes, vehicle mass ratio, ISS, DELTA V, seat belt use, and airbag deployment (AB).
In 309 F-MVC, AB reduced overall ISS (24.3 to 17.9) with a reduction in the mean severity of traumatic brain injury (TBI) GCS < or = 12, from 48% to only 28%. This AB protection from TBI was preserved as DELTA V increased to > 30 mph even though non-AB protected body areas (thorax, lung, liver, and lower extremity injuries) all increased. When vehicles of incompatible size and mass (SUVT) had F-MVC with sedans the incidence of severe TBI rose as did face lacerations despite AB or belt use. In L-MVC between SUVT and sedans compared with SvS MVC, there was a cephalad shift in body injuries with increased thorax, but decreased lower extremity injuries. The incidence of TBI increased. Analysis of injury contact sites (hits) showed more hits and a wider distribution of contract sites in SUVT vs sedan MVC. These appeared due to the greater mass excess and larger mass ratio, hood height, and width in the F-SUVT vs S crashes. All of these factors plus the increased bumper height above the body frame side-door sill were injury causal factors in the L-SUVT vs S MVCs.
Both F and L crashes between sedans and SUVT with a high mass ratio shift the pattern of injury cephalad with increased thorax and intrathoracic organ injuries, and more severe TBI. These data suggest that improved head and thorax side-impact buffering and design features which transmit MVC forces from the higher front end of the larger mass SUVT to the frame of the sedan may better protect sedan occupants from side-impacts.
使用碰撞假人的数据表明，涉及乘用车（S）与运动型多用途车、厢式货车或轻型卡车（SUVT）的机动车碰撞（MVC）比涉及两辆轿车（SvS）的碰撞造成的伤害更严重。然而，尚未有关于实际患者损伤模式或受力机制的详细数据。
在412例MVC患者（驾驶员或前排乘客）中获得损伤模式和严重程度与MVC重建数据之间的关系。对碰撞进行了检查，涉及碰撞方向、正面（F）或侧面（L）碰撞、车辆质量比、损伤严重度评分（ISS）、速度变化量（DELTA V）、安全带使用情况和安全气囊展开情况（AB）。
在309例正面MVC中，安全气囊使总体ISS降低（从24.3降至17.9），创伤性脑损伤（TBI）格拉斯哥昏迷评分（GCS）≤12的平均严重程度从48%降至仅28%。即使速度变化量增加到>30英里/小时，安全气囊对TBI的这种保护作用仍然存在，尽管未受安全气囊保护的身体部位（胸部、肺部、肝脏和下肢损伤）均有所增加。当尺寸和质量不匹配的车辆（SUVT）与轿车发生正面MVC时，尽管使用了安全气囊或安全带，严重TBI的发生率以及面部撕裂伤的发生率仍会上升。与SvS MVC相比，SUVT与轿车之间的侧面MVC中，身体损伤出现向头侧移位，胸部损伤增加，但下肢损伤减少。TBI的发生率增加。对损伤接触部位（撞击点）的分析表明，与轿车MVC相比，SUVT的撞击点更多且分布更广泛。这些情况似乎是由于在正面SUVT与轿车的碰撞中，SUVT的质量过剩更大、质量比更大、发动机罩高度和宽度更大所致。所有这些因素加上车身框架侧门槛上方保险杠高度的增加，都是SUVT与轿车侧面MVC中的损伤因果因素。
轿车与质量比高的SUVT之间的正面和侧面碰撞都会使损伤模式向头侧移位，胸部和胸腔内器官损伤增加，TBI更严重。这些数据表明，改进头部和胸部侧面碰撞缓冲以及设计特征，将MVC力从较大质量SUVT的较高前端传递到轿车框架，可能会更好地保护轿车乘客免受侧面碰撞。
