浙江省0～14岁儿童伤害急诊监测结果分析

Analysis of data from emergency-room-based injury surveillance of children aged 0 - 14 in Zhejiang Province

目的了解浙江省儿童伤害发生特点及规律，为制定相应的预防控制策略提供科学依据。方法监测2005年1月至12月首次在哨点医院（2005年浙江省医院伤害急诊监测系统有5个监测点：金华市、嵊泗县、桐乡市、宁波市鄞州区、海宁市，每个监测点设立3家哨点医院：一家县级医院、一家乡镇中心卫生院、一家乡镇卫生院，开展伤害监测工作）急诊就诊，被诊断为伤害的儿童，由经过培训的急诊室医生或护士填写统一的监测表。内容包括儿童伤害的一般情况、伤害发生的时间、地点、伤害性质等。调查在患儿神志清醒的状态下进行，调查内容要保密，当患儿不能自己回答时，可询问知道相应情况的家人或陪同者。统计学方法采用均数和构成比描述各项因素，包括性别、年龄、伤害发生时间、发生地点、发生原因、伤害严重程度等，采用Χ^2检验考察构成是否存在差异。结果2005年共监测到儿童伤害病例1794例，其中男性67．56％，女性32．44％；以本地居民为主，年龄（7．33．4-3．84）岁；最多的伤害发生地点是家中；4—11月为伤害的高发季节；伤害原因占前3位的分别是跌伤（47．94％）、交通伤（17．17％）和钝器伤（10．26％）；儿童伤害发生时的活动第一位都是空闲时（67．66％），其次是学校活动（11．25％）和运动时（9．96％）；90．33％的伤害患者经处理后回家，1．40％留观，7．04％住院，0．56％转院治疗，0．22％死亡，0．45％不详；以轻微浅表伤和中等程度伤害为主；儿童伤害最常见的3种性质是血肿瘀伤（31．29％）、浅表擦伤（23．69％）和骨折（8．67％）；受伤部位按大类分，头部占39．47％，上肢25．80％，下肢28．55％，躯干4．81％，其他1．38％。结论浙江省内儿童伤害最常见的是血肿瘀伤、浅表擦伤和骨折，伤害原因主要是跌伤、交通伤和钝器伤。儿童伤害常发生在空闲时，学校活动和运动时，因此，应加强安全教育和安全保护。

Objective To explore the characteristic and pattern of children injury of Zhejiang Province, and provides scientific evidence for the prevention and control strategy of children injury. Method Children diagnosed as injury at emergency department in sentry hospitals （There are 5 monitoring sites for injury surveillance in Zhejiang in 2005： Jinhua, Sbengsi, Tangxiang, Yinzhou district of Ningbo, Hailing; each monitoring site has 3 sentry hospitals： one county level hospital, one town center hospital and one town level hospital） from January to December, 2005 were investigated by trained doctors or nurses in emergency department. The investigation included basic information, when injury happened, where injury happened and type of injury. Children were investigated when they were conscious, and their parents or accompanies could answer if they were not able to. The contents of investigation were kept private. The distribution of variables which included sex, age, when injury happened, where injury happened, why injury happened and severity level were described mainly with proportion and means, and chisquare test was used to analyze the proportion difference. Results A total of 1 794 injury cases were recorded in 2005 among which 67.56% were nude and 32.44% were female. The majority were native people and the average age was 7.33 ± 3.84 years old. The injury occurred mostly at home and was of high frequent occurrence from April to November, The most common causes of injury were tumble （47.94%）,traffic accident （17.17%） and blunt injury（ 10.26% ）. The injury happened mostly during spare time（67.66% ）, and then school activities（ 11.25 % ） and sports activities（9.96%）. Totally 90.33% of the injured children went home ＇after been treated, 1.40% stayed for observation, 7.04% were in hospital, 0.56% were transferred to other hospitals, 0.22% died and 0.45% unknown. The slight superficial injury and moderate injury were the most common injuries. The most common three types of injury were haematoma and stasis injury（31.29% ）, superficial abrased wound（23,69 % ） and bone fracture（8.67%）. Among the injury, 39.47% were head injury, 25.80% were upper limb, 28.55% were lower limb, 4.81% were trunk and 1.38% were others. Conclusions The most common three types of injury in Zhejiang province were haematoma and stasis injury, superficial abrased wound and bone fracture. The main reasons of injury were falling injury, traffic accident injury and blunt injury. The injury happened mostly during spare time, and school activities and sports activities. Thus, safety education and ,safety protection should be strengthened to reduce children injuries.