Tso E L, Beaver B L, Haller J A
Department of Surgery, University of Maryland Medical Center, Baltimore.
J Pediatr Surg. 1993 Jul;28(7):915-9. doi: 10.1016/0022-3468(93)90696-i.
A statewide experience with pediatric abdominal visceral injury in restrained automobile passengers was compiled from the trauma registries of two academic institutions. Retrospective analysis of motor vehicle passenger injuries from 1987 to 1991 included age, sex, mechanism of injury, prehospital care, type of injury, therapeutic interventions, complications, and ultimate outcome. The records of over 2,000 patients evaluated for blunt trauma were reviewed, with 42 children fulfilling the following inclusion criteria: 15 years of age or younger, restrained in an automobile at the time of the accident, and diagnosed with an abdominal injury. Of the 42 patients studied, there were 20 boys and 22 girls; ages ranged from 2 months to 15 years (mean, 7.02 years). Six of 42 patients (14%) required extrication from the vehicle at the scene. Nineteen of 42 patients (45%) sustained belt-related abdominal wall bruising or erythema. The specific blunt visceral injuries noted were as follows: splenic 5, hepatic 5, bowel 6, renal 3, combined 6 (stomach, diaphragm, pancreas, or retroperitoneum). Twenty-three children (55%) had abdominal visceral injuries without external seat belt marks. Operative intervention was necessary in seven patients. A delay in diagnosing visceral injury occurred in 4 of 42 (10%) cases. One patient developed abdominal symptoms 72 hours after the accident. Length of hospital stay ranged from 1 to 45 days. Complications occurred in 4 (10%) of patients. There were two deaths due to injuries. Hollow and solid visceral injuries can occur in belted pediatric passengers during vehicular accidents. Both are a source of significant morbidity, and the patient should be evaluated carefully.(ABSTRACT TRUNCATED AT 250 WORDS)
通过两家学术机构的创伤登记系统，汇编了一份关于全州范围内受约束汽车乘客小儿腹部内脏损伤的经验报告。对1987年至1991年机动车乘客受伤情况进行回顾性分析，内容包括年龄、性别、损伤机制、院前护理、损伤类型、治疗干预、并发症及最终结局。审查了2000多名接受钝性创伤评估患者的记录，其中42名儿童符合以下纳入标准：15岁及以下，事故发生时系汽车安全带，并被诊断为腹部损伤。在研究的42例患者中，有20名男孩和22名女孩；年龄范围为2个月至15岁（平均7.02岁）。42例患者中有6例（14%）在现场需要从车内解救出来。42例患者中有19例（45%）出现与安全带相关的腹壁瘀伤或红斑。记录的具体钝性内脏损伤如下：脾脏损伤5例，肝脏损伤5例，肠损伤6例，肾脏损伤3例，合并伤6例（胃、膈肌、胰腺或腹膜后）。23名儿童（55%）有腹部内脏损伤但无外部安全带痕迹。七名患者需要手术干预。42例中有4例（10%）出现内脏损伤诊断延迟。一名患者在事故72小时后出现腹部症状。住院时间为1至45天。4例（10%）患者出现并发症。有两例因伤死亡。在车辆事故中，系安全带的小儿乘客可能发生中空和实性内脏损伤。两者都是严重发病的根源，应对患者进行仔细评估。（摘要截短至250字）
