Solheim K
Kirurgisk klinikk Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1998 Jun 20;118(16):2481-2.
Second only to traffic accidents, accidental falling is the most significant cause of death in children. Included in this category is a special group of accidents--falling from a height--where preventative measures would give good results. Cases of child abuse have also been found in this group. From 1989 to 1994 64 children, 19 girls and 45 boys, were treated in our surgical department after accidental falls. There were 99 injuries in all, most of them caused by falls from heights less than 2.5 m. Only two children suffered penetrating injuries. Two of the 64 children died from cerebral injuries after falling from great heights. One child died from heart tamponade, caused by rupture of the right auricle after falling down a steep staircase. One child survived a fall from a great height despite multiple injuries. In such cases, treatment is dependent on a multiple trauma team being available on a 24-hour basis. Measures to prevent falls in the home, as well as in children's playgrounds and in kindergartens are not only very important, but also easy to apply. Suspicion of child abuse must be raised where unusual injuries are observed in children who have reportedly fallen from low heights.
意外坠落在儿童死亡原因中仅次于交通事故，是第二大重要死因。这一类别中包含一类特殊的事故——从高处坠落，对此采取预防措施会有很好的效果。在这类事故中还发现了虐待儿童的案例。1989年至1994年期间，我们外科收治了64名意外坠落后的儿童，其中19名女孩，45名男孩。总共99处受伤，大多数是因从低于2.5米的高度坠落所致。只有两名儿童遭受穿透伤。64名儿童中有两名从高处坠落致颅脑损伤死亡。一名儿童因从陡峭楼梯上摔下导致右心房破裂，死于心脏压塞。一名儿童虽多处受伤但从高处坠落幸存。在这种情况下，治疗依赖于全天候待命的多创伤治疗团队。预防家庭、儿童游乐场和幼儿园内坠落的措施不仅非常重要，而且易于实施。如果在据报从低处坠落的儿童身上观察到不寻常的损伤，必须怀疑存在虐待儿童的情况。
