Adesunkanmi A R, Oginni L M, Oyelami A O, Badru O S
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
J Trauma. 1998 Mar;44(3):506-12. doi: 10.1097/00005373-199803000-00015.
A review of childhood injuries at the Wesley Guild Hospital, a component of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, showed that 1,471 patients seen in the children's emergency room during a period of 4 years (1992-1995) were there as a result of trauma, representing 9% of all patients seen. The case notes and accident and emergency cards of 1,224 were available for review. Ages ranged from 2 months to 15 years, with a mean of 6.9 years, and 40% of the patients were between 5 and 10 years of age. More males were affected than females, with a ratio of 1.5:1. Road traffic crashes were the most common causal factor, responsible for 324 injuries (26.5%). About 90% of these were pedestrians knocked down by automobiles and motorcycles. Passengers accounted for about 10% of the cases. Falls occurred in 305 patients (25%); 229 patients fell while on level ground either playing or running, accounting for 75%. There were 122 patients (10%) with misplaced foreign bodies; about 60% of these were recovered from the ears, and 26.3% from the nostrils. Edible seeds were the most common foreign bodies, followed by beads. Injuries from bites occurred in 108 patients, with dog and snake bites taking the lead. Burns, mainly from scalding, occurred in 89 patients. Other rare injuries were knife wounds, gunshot wounds, and injuries resulting from assaults. The home was the most common site of injury (570 patients, 46.7%) followed by streets or roadways (363 patients, 29.7%); 19.5% of injuries occurred at school. The most common anatomic region affected was the head and neck, followed by the limbs. One hundred ninety-seven patients (16%) had bony fractures, femurs being the most affected bone. Head injury was seen in 104 patients, representing 8.5%, although only 17 of these injuries were severe. There were 10 cases of abdominal injury and 9 cases of chest injury, representing 0.8 and 0.7%, respectively. Wound infection occurred in 6.4% of the patients. Death occurred in 19 patients, accounting for 1.6%; 10 of these patients had severe head injuries. Road traffic injuries and burns accounted for the greatest number of complications. The findings of this study suggest that trauma is an important factor in childhood morbidity and mortality in our environment, with road traffic injuries taking the lead. Preschool pedestrian children were most commonly affected, the majority of them on errands for their parents. We believe that the majority of these injuries are preventable.
对尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院综合院区下属的卫斯理公会医院儿童伤害情况进行的一项回顾显示，在4年期间（1992 - 1995年），儿童急诊室接诊的1471例患者因创伤前来就诊，占所有就诊患者的9%。可供查阅的1224例患者的病历及事故和急诊卡片显示，年龄范围为2个月至15岁，平均年龄为6.9岁，40%的患者年龄在5至10岁之间。男性受影响的人数多于女性，比例为1.5:1。道路交通事故是最常见的致病因素，导致324例受伤（26.5%）。其中约90%是被汽车和摩托车撞倒的行人，乘客约占病例的10%。305例患者（25%）发生跌倒；229例患者在平地上玩耍或奔跑时跌倒，占75%。122例患者（10%）有异物误置；其中约60%的异物从耳朵取出，26.3%从鼻孔取出。可食用种子是最常见的异物，其次是珠子。108例患者发生咬伤，以狗咬伤和蛇咬伤居多。烧伤主要是烫伤，有89例患者。其他罕见的损伤包括刀伤、枪伤和袭击所致损伤。家庭是最常见的受伤地点（570例患者，46.7%），其次是街道或道路（363例患者，29.7%）；19.5%的损伤发生在学校。最常受影响的解剖部位是头部和颈部，其次是四肢。197例患者（16%）发生骨折，股骨是受影响最严重的骨头。104例患者出现头部损伤，占8.5%，不过其中只有17例损伤严重。有10例腹部损伤和9例胸部损伤，分别占0.8%和0.7%。6.4%的患者发生伤口感染。19例患者死亡，占1.6%；其中10例患者有严重头部损伤。道路交通事故伤害和烧伤导致的并发症最多。这项研究的结果表明，在我们所处的环境中，创伤是儿童发病和死亡的一个重要因素，道路交通事故伤害居首位。学龄前步行儿童最常受到影响，他们大多数是替父母跑腿。我们认为这些损伤大多数是可以预防的。
