Juang David, Sippey Megan, Zuckerbraun Noel, Rutkoski John D, Gaines Barbara A
Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, USA.
J Trauma. 2011 Nov;71(5 Suppl 2):S531-3. doi: 10.1097/TA.0b013e31823a4bb9.
Each year, approximately 4.7 million Americans sustain dog bites, the majority of which occur in children. In response to this alarming trend, injury prevention programs across the country have focused efforts on preventing dog bites in children. However, little attention has been given to non-bite dog-related injuries, and to date, no data have been presented on this type of injury in the western literature.
After Institutional Review Board approval (IRB No. 07100185) was obtained, data from the trauma registry for all children (ages, 0-20 years) admitted to our Level I pediatric trauma center were evaluated from 2001 to 2007. Information regarding dog-related injuries was obtained. Data were divided into injuries related to bites and non-bites. Demographics, injury pattern, and outcome were evaluated. Descriptive statistics, Student's t test, and Fisher's exact/χ analyses were preformed.
Over the 6-year period reviewed, 191 (2%) children were admitted to the Benedum Trauma Program for dog-related injuries. Thirty-four (18%) children sustained non-bite-related injuries while the remainder sustained bite/scratch injuries. Twenty-six (76%) of the children sustained injuries directly due to contact with dogs; four (12%) of them were injured after falling while being carried by adults who either tripped over a dog or were pushed by a dog. The remaining four (12%) children sustained injuries while colliding with dogs while on motorized and/or nonmotorized vehicles. Abrasions/lacerations and head injury occurred most frequently, followed by extremity fractures, particularly of the femur. Children injured by non-bite-related mechanisms were more severely injured than those sustained a bite, although the Injury Severity Score in both groups was low.
Dog bites have been recognized around the world as a substantial public health problem particularly in children. In our experience, we have seen that non-bite-related injuries should not be ignored. The injuries seen in this subset of children are the result of being struck or pushed, resulting in multiple, potentially severe injuries. These data underscore the unpredictable nature of animals and the need for adult supervision when animals and children interact.
每年约有470万美国人遭受犬咬伤，其中大多数发生在儿童身上。针对这一惊人趋势，全国各地的伤害预防项目都将工作重点放在预防儿童犬咬伤上。然而，与犬相关的非咬伤伤害却很少受到关注，迄今为止，西方文献中尚未有关于此类伤害的数据。
在获得机构审查委员会批准（IRB编号：07100185）后，对2001年至2007年期间入住我们一级儿科创伤中心的所有儿童（年龄0至20岁）的创伤登记数据进行评估。获取与犬相关伤害的信息。数据分为咬伤相关伤害和非咬伤相关伤害。对人口统计学、损伤模式和结果进行评估。进行描述性统计、学生t检验和费舍尔精确检验/χ分析。
在审查的6年期间，有191名（2%）儿童因与犬相关的伤害入住贝内德姆创伤项目。34名（18%）儿童遭受非咬伤相关伤害，其余儿童遭受咬伤/抓伤。26名（76%）儿童因直接与犬接触而受伤；其中4名（12%）儿童是在被成年人抱着摔倒后受伤的，这些成年人要么被狗绊倒，要么被狗推搡。其余4名（12%）儿童在乘坐机动和/或非机动车辆时与狗碰撞受伤。擦伤/撕裂伤和头部受伤最为常见，其次是四肢骨折，尤其是股骨骨折。非咬伤相关机制受伤的儿童比咬伤儿童受伤更严重，尽管两组的损伤严重程度评分都很低。
犬咬伤在世界各地都被认为是一个严重的公共卫生问题，尤其是在儿童中。根据我们的经验，我们发现非咬伤相关伤害不应被忽视。这部分儿童所受的伤害是被撞击或推搡的结果，会导致多处潜在的严重伤害。这些数据强调了动物的不可预测性以及动物与儿童互动时成人监督的必要性。
