Zhu Huiping, Gao Qi, Xia Xin, Xiang Joe, Yao Hongli, Shao Jianbo
School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Beijing 100069, China.
Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
Int J Environ Res Public Health. 2014 Mar 26;11(4):3493-506. doi: 10.3390/ijerph110403493.
This study investigated injury patterns and the use of computed tomography (CT) among Chinese children with mild traumatic brain injury (MTBI). We enrolled children with MTBI who were treated within 24 hours of head trauma in the emergency department of Wuhan Medical Care Center for Women and Children in Wuhan, China. Characteristics of MTBIs were analyzed by age and gender. Results of cranial CT scan and clinically-important brain injury (ciTBI) for children were obtained. The definition of ciTBI was: death from TBI, intubation for more than 24 h for TBI, neurosurgery, or hospital admission of 2 nights or more. Of 455 eligible patients with MTBI, ciTBI occurred in two, and no one underwent neurosurgical intervention. CT scans were performed for 441 TBI patients (96.9%), and abnormal findings were reported for 147 patients (33.3%, 95% CI 29.0-37.8). Falls were the leading cause of MTBI (61.5%), followed by blows (18.9%) and traffic collisions (14.1%) for children in the 0-2 group and 10-14 group. For children aged between 3 and 9, the top three causes of TBI were falls, traffic collisions and blows. Leisure activity was the most reported activity when injuries occurred for all age groups. Sleeping/resting and walking ranked in the second and third place for children between 0 and 2 years of age, and walking and riding for the other two groups. The places where the majority injuries occurred were the home for the 0-2 and 3-9 years of age groups, and school for the 10-14 years of age group. There was no statistical difference between boys and girls with regard to the activity that caused the MTBI. This study highlights the important roles that parents and school administrators in the development of preventive measures to reduce the risk of traumatic brain injury in children. Also, identifying children who had a head trauma at very low risk of clinically important TBI for whom CT might be unnecessary is a priority area of research in China.
本研究调查了中国轻度创伤性脑损伤（MTBI）儿童的损伤模式及计算机断层扫描（CT）的使用情况。我们纳入了在中国武汉妇女儿童医疗保健中心急诊科于头部外伤后24小时内接受治疗的MTBI儿童。根据年龄和性别分析MTBI的特征。获取了儿童颅脑CT扫描结果及具有临床意义的脑损伤（ciTBI）情况。ciTBI的定义为：因创伤性脑损伤（TBI）死亡、因TBI插管超过24小时、接受神经外科手术或住院两晚及以上。在455例符合条件的MTBI患者中，2例发生了ciTBI，且无人接受神经外科干预。441例TBI患者（96.9%）进行了CT扫描，147例患者（33.3%，95%可信区间29.0 - 37.8）报告有异常发现。跌倒为MTBI的主要原因（61.5%），0 - 2岁组和10 - 14岁组儿童中，其次是打击伤（18.9%）和交通碰撞伤（14.1%）。对于3至9岁儿童，TBI的前三大原因是跌倒、交通碰撞和打击伤。所有年龄组受伤时最常报告的活动是休闲活动。0至2岁儿童受伤时，睡觉/休息和行走分别排在第二和第三位，其他两组则是行走和骑行。0至2岁和3至9岁年龄组大多数损伤发生在家中，10至14岁年龄组则发生在学校。导致MTBI的活动在男孩和女孩之间无统计学差异。本研究强调了家长和学校管理人员在制定预防措施以降低儿童创伤性脑损伤风险方面的重要作用。此外，在中国，识别出头部外伤后发生具有临床意义的TBI风险极低且可能无需进行CT检查的儿童是一个优先研究领域。
