高海拔地区儿童眼外伤住院患儿致伤因素的真实世界研究

A hospital-based real-world study of factors causing ocular trauma in children at high altitudes

目的分析高海拔地区的儿童眼外伤患者致伤因素分布及其相关影响因素。方法回顾性单中心横断面真实世界研究。收集西藏自治区人民医院于2019年9月1日至2020年8月31日就诊的眼外伤患者的电子病历资料,筛选年龄<18岁的患儿,统计性别、年龄、是否为学生、居住地以及具体致伤原因。进一步将致伤原因分为钝器伤与非钝器伤,利用四格表卡方检验比较不同性别、不同年龄段、是否为学生、不同居住地的致伤原因是否存在差异。结果共纳入259名儿童眼外伤患者,占眼外伤患者总量的28.59%(259/906)。患儿年龄为1~17岁,其中男性患儿185人占71.43%,女性患儿74人占28.57%。≤6岁者138例(53.28%),>6岁者121例(46.72%);学生121例(46.72%),非学生138例(53.28%);居住于城市者196例(75.68%),居住于农牧山区者63例(24.32%)。具体致伤原因包括钝器伤194例(74.903%),锐器伤48例(18.533%),异物伤4例(1.544%),动物或植物伤6例(2.317%),其他伤7例(2.703%)。其中在钝器伤和非钝器伤患儿中,性别(男147∶38,女47∶27,χ^(2)=7.15,P=0.007)、是否为学生(学生97∶24,非学生97∶41,χ^(2)=3.35,P=0.045)、居住地(城市158∶38,农牧山区36∶27,χ^(2)=13.97,P<0.001)等方面差异均具有统计学意义;而年龄是否超过6岁(>6岁94∶27,≤6岁100∶38,χ^(2)=0.94,P=0.333)差异无统计学意义。结论高海拔地区儿童眼外伤致伤因素以钝器伤为主,表现出多样性;男性患儿、城市患儿为钝器伤高发的相关因素,非学生中的非钝器伤相对高发。

Objective To analyze the distribution of injury factors and its related factors on children with ocular trauma at high altitudes.Methods This was a retrospective,single-center,cross-sectional,real-world study.The electronic medical records of patients with ocular trauma who attended the People′s Hospital of the Tibet Autonomous Region from Sep.1st,2019,to Aug.31st,2020 were collected.Children aged<18 years were selected to record gender,age,whether students,residence and specific causes of ocular trauma.The causes of ocular trauma were divided into blunt trauma and non-blunt trauma.The four-table chi-square test was used to compare whether significant differences existed between blunt trauma and non-blunt trauma with different genders,different age groups,whether students or not,and different places of residence.Results The clinical data of 259 children with ocular trauma were analyzed,accounting for 28.59%(259/906)of the total ocular trauma.The age of the children ranged from 1 year to 17 years.Among them,185 cases(71.43%)were male,74 cases(28.57%)were female;138 cases(53.28%)were≤6 years old,121 cases(46.72%)were>6 years old;121 cases(46.72%)were students,138 cases(53.28%)were non-students;196 cases(75.68%)lived in cities and 63 cases(24.32%)lived in agricultural and pastoral areas.The distribution of specific causes to ocular trauma declared as the following;194 cases(74.903%)by blunt instruments,48 cases(18.533%)by sharp instruments,4 cases(1.544%)by foreign bodies,6 cases(2.312%)by animals or plants,and 7 cases(2.703%)by other injuries.Gender(male 147∶38,female 47∶27,χ^(2)=7.15,P=0.007),whether students(students 97∶24,non-students 97∶41,χ^(2)=3.35,P=0.045),and residence(cities 158∶38,agricultural and pastoral areas 36∶27,χ^(2)=13.97,P<0.001)were significantly different between blunt trauma and non-blunt trauma in children;while no significant differences in age(>6 years old 94∶27,≤6 years old 100∶38,χ^(2)=0.94,P=0.333)were found.Conclusion The main cause of ocular trauma in children at high altitudes are blunt instruments with diversified nature;gender of male and urban residence are related factors for high incidence of blunt trauma,and non-student identify is a relatively high incidence of non-blunt trauma.