Christensen Tyler L, Brandes Steven B
Division of Urologic Surgery, Washington University in St. Louis, St Louis, MO 63110, USA.
South Med J. 2008 Apr;101(4):383-7. doi: 10.1097/SMJ.0b013e318167a851.
Hunting is a popular recreational pastime in the United States. Injuries sustained from falls out of tree stands remain a significant cause of morbidity among hunters, often resulting in significant urological injury. The purpose of this study is to identify the type and pattern of urologic injuries sustained after free falls from hunting tree stands.
A retrospective review was performed using an institutional trauma database. Twenty patients who sustained urologic trauma when falling from a hunting tree stand were identified from 1998 to 2006. Baseline data, type of injury, and management strategies were recorded.
All patients were male with a mean age of 43. Mean fall height was 15.2 feet. Ninety-five percent of hunters were not wearing a fall-arrest system/full body harness. Sixty-three percent of injuries were the result of human error, whereas 26% resulted from structural failure. Ten percent of injuries were associated with alcohol use. Urologic injuries included: 2 posterior urethral disruptions, 8 renal injuries, and 10 spinal cord injuries resulting in permanent paralysis and neurogenic bladder.
Accidental falls from hunting tree stands can cause significant urologic morbidity. Fall-arrest system/full body harness use and increased hunter public education and awareness can reduce tree stand falls. Trauma teams need to be aware of the potential for urologic injury, and need to evaluate and treat hunters involved in tree stand accidents accordingly.
狩猎在美国是一项受欢迎的娱乐消遣活动。从树上狩猎台跌落所致损伤仍是猎人发病的一个重要原因，常导致严重的泌尿系统损伤。本研究的目的是确定从狩猎树上自由跌落之后所遭受的泌尿系统损伤的类型和模式。
使用机构创伤数据库进行回顾性研究。从1998年至2006年期间，确定了20例从狩猎树上跌落时遭受泌尿系统创伤的患者。记录基线数据、损伤类型和治疗策略。
所有患者均为男性，平均年龄43岁。平均跌落高度为15.2英尺。95%的猎人未使用防坠落系统/全身安全带。63%的损伤是人为失误导致的，而26%是结构故障所致。10%的损伤与饮酒有关。泌尿系统损伤包括：2例后尿道断裂、8例肾损伤以及10例导致永久性瘫痪和神经源性膀胱的脊髓损伤。
从狩猎树上意外跌落可导致严重的泌尿系统发病。使用防坠落系统/全身安全带以及加强对猎人的公众教育和提高其意识可减少从树上跌落的情况。创伤团队需要意识到存在泌尿系统损伤的可能性，并需要相应地对涉及树上事故的猎人进行评估和治疗。
