2286例儿童意外伤害的临床分析

Unintentional injuries in children：2 286 cases analysis

目的分析儿童意外伤害的临床特点，为儿童意外伤害的预防及干预提供有价值的信息。方法回顾性分析2013年1月至2015年12月广西医科大学第一附属医院收治的0～14岁意外伤害儿童的临床资料。结果收集病例2 286例，男1 507例（65.92%），女779例（34.08%），高发年龄为1～3岁896例（39.19%）。意外伤害原因前5位分别为：烧/烫伤840例（36.74%）、坠落/跌倒464例（20.30%）、钝器伤290例（12.68%）、各种异物（食道或气道等）253例（11.07%）、利器伤153例（6.68%）；不同年龄意外伤害种类有差别，1～3岁组以烧/烫伤及各种异物（食道或气道等）多见，6～14岁组以坠落/跌倒及钝器伤为主；农村儿童发生意外伤害1 547例（67.67%），城市儿童739例（32.33%）；意外伤害后果较严重的是：钝器伤55例（26.96%）、利器伤45例（22.06%）、烧/烫伤26例（12.75%）、爆炸伤23例（11.27%）及坠落/跌倒20例（9.80%）。发生伤残/后遗症204例（8.92%），死亡10例（0.44%）。死亡病例中以坠落/跌倒4例、交通意外3例居多。结论儿童意外伤害高危人群是1～3岁幼儿，以烧/烫伤及各种异物（食道或气道等）为主，男孩多于女孩。农村儿童发生意外伤害比例高于城市。儿童意外伤害后果较严重的是钝器伤、利器伤、烧/烫伤、爆炸伤及坠落/跌倒，死亡病例中以坠落/跌倒、交通意外居多。加强儿童意外伤害防范知识的宣传，是减少儿童意外伤害发生的关键。

Objective To investigate the clinical features of unintentional injuries in children,and to provide the theoretical basis for preventing and intervening the occurrence. Methods We collected the data of children aged from 0 to 14 years old and hospitalized in the First Affiliated Hospital of Guangxi Medical University from January 2013 to December 2015. Results There were 2 286 cases of children including 1 507 boys（65.92% ） and 779 girls（34. 08% ）. The high incidence age was 1 to 3 years with a total of 896 cases （39. 19 % ）. The first five causes of unintentional injuries were bums/scalds 840 cases （36.71% ）, fall/ drop 464 cases（ 20. 30% ） ,blunt force injury 290 cases（ 12. 68% ）, foreign bodies（ in the esophagus, airway, etc） 253 cases（ 11.07% ） ,and sharp object injury 153 cases（6.68% ）. The unintentional injuries of different age group were varied, for example, the common causes of 1 to 3 years old group were bums/scalds and foreign bodies（in the esophagus,ailavay,etc） ,and the main injuries in 6 to 14 years old group were fall/drop and blunt force. Furthermore, the proportion of unintentional injuries in rural children was 1 547 cases （67.67%） ,and in the urban children was 739 cases （32. 33% ）. Unintentional injury with serious consequences included bums/scalds 55 cases （26. 96% ）, sharp object injury 45 cases （22. 06% ）, bums/scalds 26 cases （12. 75% ）, blast injury of 23 cases （11.27% ） and fall/drop 20 cases （9. 80% ）. Disable/sequel happened in 204 cases（8. 92% ）. Ten cases died（0.44% ） including fall/drop in 4 cases,traffic accident in 3 cases（30% ）. Conclusion Young children aged 1 to 3 years are the most vulnerable to unintentional injures. Burus/scalds and foreign bodies （in the esophagus, airway, etc） are the most common causes of injuries, and the boys are more common than girls. Moreover, the incidence rate of unintentional trauma in rural children was higher than that in the urban children. Unintentional injury complicated serious consequences are burns/scalds, sharp object injury, blast injury and fall/drop. Death cases in the majority are fall/drop and traffic accident. The key to reduce the occurrence of unintentional injuries is to strengthen propaganda of prevention knowledge about the children＇s unintentional injuries.