儿童面部外伤急诊处理

Emergency plastic treatment in children＇s facial injury

目的 分析儿童面部外伤的特点及总结急诊修复经验,为达到最佳治疗效果提供依据.方法 对过去8年间（2004年1月至2011年12月）收治的1407例儿童面部外伤的病因、年龄分布、急诊处理等进行回顾性分析.结果 1407例患儿中绝大多数（1196/1407,85.0％）为皮肤挫裂伤;最常见外伤原因为摔伤（1154/1407,82.0％）;最常见部位为额部（562/1407,39.9％）、颏部（211/1407,15.0％）、口唇（196/1407,13.9％）及鼻部（95/1407,6.8％）,即“T”区;2岁和5岁是儿童最易发生面部外伤的年龄.经过规范化的整形外科急诊清创缝合后,临床疗效均较为理想.经过3～6个月随访发现：其中5例早期感染;27例瘢痕增生较明显;7例继发外伤性文身.结论 儿童面部外伤急诊处理时,应充分考虑儿童自身的生理和心理特点,尽量遵循整形外科的原则,在伤口Ⅰ期愈合的同时使瘢痕最微小,达到最佳的美容效果.

Objective To analyze and summarize the features of children＇s facial wound and to share the emergency treatment experiences.Methods An retrospective study was conducted on the pathogenesis,age distribution,emergency treatment methods and complications in 1407 children （under 15 years of age） during recent 8 years （from January 2004 to December 2011）.Results In this study the major facial wound type was simply lacerations （1196/1407,85.0 ％）,and the most common wound cause was trumbling injury （1154/1407,82.0 ％）.The ＂T＂ area was the easiest injured,successively,forehead （562/1407,39.9％）,chin （211/1407,15.0％）,lips （196/1407,13.9％） and nose （95/1407,6.8％）.Here were 2 peaks in age distribution which were 2 and 5 years of age,respectively.Pleased outcome would be found while normalized plastic means were taken.After 3 to 6 months following up,there were 5 infection cases,27 cases healed with hypertrophic scars,and 7 cases with traumatic tattoos in wound location.Conclusions The most common wound type is simply laceration.2 and 5 years of age are two of the highest risk stages.It is necessary to act up to plastic surgery principles and take children＇s particularity into account when emergency treatment,and to do our best to minimize the scar in the first operation time.