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印度南部一家三级护理医院急诊科就诊患儿的创伤概况。

Profile of Pediatric Trauma among the Patients Attending Emergency Department in a Tertiary Care Hospital in South India.

作者信息

Prakash Raju K N J, Jagdish S, Kumar G Krishna, Anandhi D, Antony Jency

机构信息

Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

J Emerg Trauma Shock. 2020 Jan-Mar;13(1):62-67. doi: 10.4103/JETS.JETS_149_18. Epub 2020 Mar 19.

Abstract

BACKGROUND

Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric trauma is different in different parts of the world. There are very few studies describing the pediatric trauma in developing countries.

OBJECTIVES

The objectives of this study were to assess the type, mechanism, and extent of trauma among pediatric trauma patients and its association with clinical outcome.

METHODOLOGY

This was a prospective observational study conducted in the department of emergency medicine and trauma at a tertiary care hospital in South India from September 2015 to March 2017. All children aged <12 years with a history of injuries irrespective of the cause for attending our trauma center were included in the study.

OBSERVATIONS AND RESULTS

Of the 911 children enrolled, 63.9% sustained injuries at home. The leading modes of injury were fall at level ground (26.9%), road traffic accidents (RTAs) (25.5%), and fall from height (16.8%). Majority of RTA victims were two-wheeler pillion riders (40.5%) and pedestrians (31.9%). Nearly 49% of children had head and maxillofacial injuries. Polytrauma was found in 3.6% of children. Based on the Pediatric Trauma Score (PTS), 72.6% of children had mild trauma and 6.1% severe trauma. Totally, 18.9% of children required inpatient management, 7.5% surgical intervention, and 1.8% expired.

CONCLUSIONS

Most of injuries in children occurred at home. This was followed by injuries on road. The leading cause of polytrauma was RTA. RTA victims were more likely to have severe injuries and poor outcome. They were more likely to require inpatient management compared to those who fell from height or fell at level ground. Glasgow Coma Scale and PTS may be used reliably to assess the severity of injuries sustained by children.

摘要

背景

儿童创伤在全球范围内正成为一种流行病;世界不同地区儿童创伤的流行病学情况有所不同。描述发展中国家儿童创伤的研究非常少。

目的

本研究的目的是评估儿童创伤患者的创伤类型、机制和程度及其与临床结局的关联。

方法

这是一项前瞻性观察性研究,于2015年9月至2017年3月在印度南部一家三级护理医院的急诊医学与创伤科进行。所有年龄小于12岁且有受伤史的儿童,无论其前往我们创伤中心的原因,均纳入本研究。

观察结果

在纳入的911名儿童中,63.9%在家中受伤。主要的受伤方式为平地摔倒(26.9%)、道路交通事故(25.5%)和高处坠落(16.8%)。道路交通事故受害者多数为两轮摩托车后座乘客(40.5%)和行人(31.9%)。近49%的儿童有头部和颌面损伤。3.6%的儿童存在多发伤。根据儿童创伤评分(PTS),72.6%的儿童为轻度创伤,6.1%为重度创伤。共有18.9%的儿童需要住院治疗,7.5%需要手术干预,1.8%死亡。

结论

儿童受伤大多发生在家中。其次是道路上的受伤。多发伤的主要原因是道路交通事故。道路交通事故受害者更有可能受到重伤且预后较差。与从高处坠落或平地摔倒的儿童相比,他们更有可能需要住院治疗。格拉斯哥昏迷量表和儿童创伤评分可可靠地用于评估儿童所受损伤的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f1/7204961/64127dc9198b/JETS-13-62-g001.jpg

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