German John W, Klugh Arnett, Skirboll Stephen L
Division of Neurosurgery, Albany Medical Center, Albany, New York, USA.
J Neurosurg. 2007 May;106(5 Suppl):368-71. doi: 10.3171/ped.2007.106.5.368.
Falls from pickup truck cargo areas represent a unique mode of injury in children and adolescents. The goal of this study was to identify the neurological spectrum of injuries resulting from children riding in the back of pickup trucks.
The authors undertook a retrospective review of the University of New Mexico Hospital trauma registry of data compiled over a 7-year period. Their goal was to identify instances in which a fall or ejection from a pickup truck cargo area was the mechanism of injury. The charts of pediatric patients (< or = 16 years of age) with neurological injuries were reviewed and analyzed. Seventy-three pediatric patients with injuries related to riding in the cargo areas of trucks were identified, of which 53 children (73%) had sustained neurological injuries. Among these 53 children, 64% sustained isolated head injuries, 15% isolated spine injuries, 9.4% combined spine and head injuries, 2% combined peripheral nerve, spine, and head injuries, 4% isolated peripheral nerve injuries, and 5.6% concussive events. In 53.4% of patients with neurological injuries the results of computed tomography (CT) examination were abnormal. In 36% of patients with Glasgow Coma Scale (GCS) scores of 14 to 15 there was evidence of intracranial hemorrhage on head CT scans. Injury Severity Scores were similar in the patients who were ejected and those who fell from cargo areas, but patients who were ejected had a lower mean GCS score than those who suffered falls (GCS score 12.5 and 14.3, respectively).
Falls or ejections from pickup truck cargo areas result in a relatively high incidence of traumatic head, spine, and peripheral nerve injury. Head CT scanning should therefore be considered in pediatric patients with this mechanism of injury. Cargo area occupancy poses an unacceptable risk of injury and should be avoided.
从皮卡货厢区域坠落是儿童和青少年一种独特的受伤方式。本研究的目的是确定儿童乘坐皮卡后部所导致损伤的神经损伤谱系。
作者对新墨西哥大学医院创伤登记处7年期间收集的数据进行了回顾性研究。他们的目标是确定从皮卡货厢区域坠落或被弹出作为损伤机制的病例。对患有神经损伤的儿科患者（≤16岁）的病历进行了回顾和分析。确定了73例与乘坐卡车货厢区域相关的儿科损伤患者，其中53名儿童（73%）遭受了神经损伤。在这53名儿童中，64%为单纯头部损伤，15%为单纯脊柱损伤，9.4%为脊柱和头部联合损伤，2%为周围神经、脊柱和头部联合损伤，4%为单纯周围神经损伤，5.6%为脑震荡事件。在53.4%的神经损伤患者中，计算机断层扫描（CT）检查结果异常。在格拉斯哥昏迷量表（GCS）评分为14至15分的患者中，36%的头部CT扫描显示有颅内出血迹象。被弹出的患者和从货厢区域坠落的患者的损伤严重程度评分相似，但被弹出的患者平均GCS评分低于坠落的患者（分别为GCS评分12.5和14.3）。
从皮卡货厢区域坠落或被弹出会导致相对较高的创伤性头部、脊柱和周围神经损伤发生率。因此，对于有这种损伤机制的儿科患者应考虑进行头部CT扫描。货厢区域载人会带来不可接受的受伤风险，应予以避免。
