Masudi Tahir, McMahon Helen Capitelli, Scott Jennifer L, Lockey Andrew S
Department of Emergency Medicine, Huddersfield Royal Infirmary, Huddersfield, UK.
Department of General Surgery, York District General Hospital, York, UK.
J Emerg Trauma Shock. 2017 Apr-Jun;10(2):70-73. doi: 10.4103/0974-2700.201590.
Legislation making seatbelt use mandatory is considered to have reduced fatal and serious injuries by 25%, with UK government estimates predicting more than 50,000 lives saved since its introduction. However, whilst the widespread use of seatbelts has reduced the incidence of major traumatic injury and death from road-traffic collisions (RTCs), their use has also heralded a range of different injuries. The first ever seatbelt related injury was described in 1956, and since then clear patterns of seatbelt-related injuries have been recognised.
This review of the published literature demonstrates that the combination of airbags and three-point seatbelts renders no part of the body free from injury. Serious injuries can, and do, occur even when passengers are properly restrained and attending clinicians should have a high index of suspicion for overt or covert intra-abdominal injuries when patients involved in RTCs attend the Emergency Department. Bruising to the trunk and abdomen in a seatbelt distribution is an obvious sign that suggests an increased risk of abdominal and thoracic injury, but bruising may not be apparent and its absence should not be falsely reassuring. A high index of suspicion should be retained for other subtler signs of injury. Children and pregnant women represent high-risk groups who are particularly vulnerable to injuries.
In this review we highlight the common patterns of seatbelt-related injuries. A greater awareness of the type of injuries caused by seatbelt use will help clinicians to identify and treat overt and covert injuries earlier, and help reduce the rates of morbidity and mortality following RTCs.
强制使用安全带的立法被认为使致命和重伤事故减少了25%，据英国政府估计，自实施以来已挽救了超过50000人的生命。然而，虽然安全带的广泛使用降低了道路交通碰撞（RTC）导致的重大创伤性损伤和死亡的发生率，但安全带的使用也带来了一系列不同的损伤。1956年首次描述了与安全带相关的损伤，从那时起，与安全带相关的损伤的清晰模式已得到确认。
对已发表文献的综述表明，安全气囊和三点式安全带的组合并不能使身体任何部位免受伤害。即使乘客得到妥善约束，严重损伤仍可能且确实会发生，当涉及RTC的患者前往急诊科时，主治医生应对明显或隐匿的腹腔内损伤保持高度怀疑。安全带分布区域的躯干和腹部出现瘀伤是一个明显迹象，表明腹部和胸部受伤的风险增加，但瘀伤可能不明显，其不存在也不应让人误以为安全而放松警惕。对于其他更细微的损伤迹象仍应保持高度怀疑。儿童和孕妇是特别容易受伤的高危群体。
在本综述中，我们强调了与安全带相关的损伤的常见模式。提高对安全带使用所造成损伤类型的认识将有助于临床医生更早地识别和治疗明显和隐匿的损伤，并有助于降低RTC后的发病率和死亡率。
