Hegde Shalini, Bawa Monika, Kanojia Ravi P, Mahajan Jai K, Menon Prema, Samujh Ram, Rao K L N
Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Indian Assoc Pediatr Surg. 2020 May-Jun;25(3):142-146. doi: 10.4103/jiaps.JIAPS_35_19. Epub 2020 Apr 11.
The aim is to prospectively study 125 trauma patients admitted in the pediatric surgery ward in our institute.
Pediatric patients admitted in the ward after initial resuscitation in the triage room were included. Isolated neurosurgical and orthopedic injuries were excluded. X-ray cervical spine, hip, and chest and a focused assessment with sonography in trauma ultrasound were done for all patients. Computed tomography of the abdomen or chest was done where relevant. Injury profile and surgical intervention when needed were analyzed.
Road traffic accidents and fall from height caused 73.6% of the injuries. School-going children were most commonly affected (60.8%). Distinctive injuries were noted such as abdominal wall hernias and delayed bladder perforation. All solid organ injury irrespective of grade treated conservatively. Forty percent of the children required surgical intervention. Five patients after laparotomy were found to have surgical conditions unrelated to trauma, whereas another 14 required delayed surgery. Five patients had injuries secondary to sexual abuse. All except two patients were discharged in a satisfactory condition and are doing well in the follow-up.
In spite of extensive injuries and the need for multiple surgeries, children with trauma have a good prognosis. Close observation during admission and also in follow-up are essential, as many patients may require delayed surgery ≥1 week from injury.
前瞻性研究我院小儿外科病房收治的125例创伤患者。
纳入在分诊室经初步复苏后收入病房的小儿患者。排除单纯的神经外科和骨科损伤。对所有患者进行颈椎、髋关节和胸部X线检查以及创伤超声重点评估。必要时进行腹部或胸部计算机断层扫描。分析损伤情况及必要时的手术干预措施。
道路交通事故和高处坠落导致73.6%的损伤。学龄儿童受影响最为常见（60.8%）。发现了一些特殊损伤，如腹壁疝和延迟性膀胱穿孔。所有实性器官损伤无论分级均采用保守治疗。40%的儿童需要手术干预。剖腹手术后发现5例患者的手术情况与创伤无关，另有14例需要延期手术。5例患者有性虐待所致损伤。除2例患者外，所有患者均顺利出院，随访情况良好。
尽管创伤患儿损伤广泛且需要多次手术，但预后良好。入院期间及随访时密切观察至关重要，因为许多患者可能在受伤≥1周后需要延期手术。
