交通事故后泌尿生殖系统损伤：对162,690名受害者登记资料的分析
Genitourinary injuries after traffic accidents: Analysis of a registry of 162,690 victims.
作者信息
Terrier Jean-Etienne, Paparel Philippe, Gadegbeku Blandine, Ruffion Alain, Jenkins Lawrence C, N'Diaye Amina
机构信息
From the Department of Urology (J.E.T., P.P., A.R.), Centre Hospitalier Lyon Sud, Lyon, France; UMR Epidémiologique et de Surveillance Transport Travail Environnement. IFSTTAR (French Institute of Science and Technology for Transport, Spatial Planning, Development and Networks) (B.G., A.N.), Université Lyon1, Universités de Lyon, Lyon, France; and Department of Urology (L.C.J.), The Ohio State University, Columbus, Ohio.
出版信息
J Trauma Acute Care Surg. 2017 Jun;82(6):1087-1093. doi: 10.1097/TA.0000000000001448.
BACKGROUND
Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries after trauma have been well described. However, there exists a paucity of data on other traumatic GUI after traffic accidents. The objective of this study was to analyze the frequency and type of all GUI, by user category, after traffic accidents.
METHODS
Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale and the Injury Severity Score. Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma. Multivariate prediction models were used for analysis of data.
RESULTS
Of 162,690 victims, 963 presented with GUI (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%), and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the American Association for the Surgery of Trauma kidney injuries were grade I, 59%; grade II, 11%; grade III, 16%; grade IV, 9%; grade V, 3%; and indeterminate, 2%.
CONCLUSION
GUI is an infrequent trauma after traffic accidents, with kidneys being the most commonly injured. Physicians must maintain a high awareness for external genitalia injuries in motorcyclists and cyclists.
LEVEL OF EVIDENCE
Prognostic and epidemiologic study, level III.
背景
交通事故是泌尿生殖系统损伤（GUI）最常见的原因。创伤后肾损伤已有详尽描述。然而，关于交通事故后其他创伤性泌尿生殖系统损伤的数据却很匮乏。本研究的目的是按用户类别分析交通事故后所有泌尿生殖系统损伤的频率和类型。
方法
从法国罗纳省1996年至2013年的创伤登记处提取患者病例。我们评估了每个道路使用者类别所呈现的泌尿生殖系统损伤情况。严重损伤采用简明损伤定级标准和损伤严重度评分进行编码。肾创伤依据美国创伤外科协会的分类法进行映射。使用多变量预测模型进行数据分析。
结果
在162,690名受害者中，963人出现泌尿生殖系统损伤（0.59%）。47%为摩托车手，22%为汽车驾乘人员，18%为骑自行车者，9%为行人。最常见的器官损伤是肾脏（41%），其次是睾丸（23%）。在208名有泌尿生殖系统损伤的驾车者中，肾脏（70%）、膀胱（10%）和肾上腺（9%）是最常见的损伤部位。在453名有泌尿生殖系统损伤的摩托车手受害者中，肾脏（35%）和睾丸（38%）创伤最为常见，62%的损伤涉及外生殖器。有175名骑自行车者出现泌尿生殖系统损伤，70%的损伤涉及外生殖器；阴茎创伤（23%）最为常见。总共发生了395例肾损伤，大多数为低级别损伤。根据美国创伤外科协会的分类，肾损伤为I级的占59%；II级占11%；III级占16%；IV级占9%；V级占3%；不确定级占2%。
结论
泌尿生殖系统损伤是交通事故后较少见的创伤，其中肾脏是最常受伤的器官。医生必须对摩托车手和骑自行车者的外生殖器损伤保持高度警惕。
证据级别
预后和流行病学研究，III级。
Zotero 插件