芦山地震中主动性高处坠落伤的伤情分析

A retrospective analysis of intentional free-fall injury in Lushan earthquake

目的探讨芦山地震中主动性高处坠落伤的损伤情况和临床特点。方法对芦山地震中早期收治的74例伤员资料进行回顾性分析，筛选出20例主动性高处坠落伤伤员，均为男性；年龄14～57岁，平均29．4岁。分析此20例伤员的坠落高度、骨折部位及损伤严重程度等资料，并应用简明创伤分度和损伤严重度评分（ISS）进行创伤评分。根据ISS评分分为轻度伤组和中重度伤组，分析年龄、坠落高度与损伤严重程度是否存在关联。结果20例伤员坠落高度为2～6m，平均3．7m。骨折部位：跟骨骨折10例，其中双侧5例，单侧5例；胸腰椎骨折9例，其中简单骨折5例，爆裂骨折4例（不全瘫2例）；上肢骨折3例；下肢骨折3例。ISS评分为4～16分，平均9．0分，以轻、 中度损伤为主。轻度伤组与中重度伤组伤员的年龄、坠落高度比较差芹均无统计学意义（P〉0．05），年龄、坠落高度与损伤严重程度问无明显十日关性。结论芦山地震叶1主动坠落伤有着与自杀性主动坠落伤及被动黔落伤明显不同的伤情特点，应根据其特点采取相应的救治措施。

Objective To analyze the clinical characteristics of intentional free-fall injury in the Lushan earthquake. Methods Twenty patients who had got injured after an intentional free-fall were screened from the 74 victims who were treated in our hospital for their injuries caused in the Lushan earthquake. They were all males, aged from 14 to 57 years （average, 29.4 years）. After their injuries were graded by the abbreviated injury score （AIS） and injury severity score （ISS） systems, they were classified into 2 groups according to their ISS： a mild injury group and a moderate-to-serious group. Associations among falling height, fracture site and injury severity were explored using SPSS19.0. Results The falling heights of the 20 patients ranged from 2 to 6 meters, averaging 3.7 meters. Calcaneus fracture occurred in 10 cases, including 5 bilateral roles and 5 unilateral ones. Thoracolumbar fracture occurred in 9, including 5 simple ones and 4 burst ones （2 cases of incomplete paralysis）. Lower extremity fi＇acture occurred in 3 and upper extremity fracture in 3. Their ISS ranged from 4 to 16 points, averaging 9.0 points. Most injuries were mild to moderate. Statistical analysis found no significant association of injury severity with falling height or age. Conclusions Injuries suffered hy Lushan earthquake victims after an intentioual free-fall are quite different from those by suicidal jumpers or non-intentional falling victims. Individualized treatment measures should be taken according to the specific characteristics of fracture and injury for these patients.