Radiological findings of February 2023 twin earthquakes-related spine injuries

BACKGROUND The February 6,2023,twin earthquakes in Türkiye caused significant structural damage and a high number of injuries,particularly affecting the spine,which underscores the importance of understanding the distribution and nature of vertebral injuries in disaster victims.AIM To investigate the distribution of radiological findings of vertebral injuries in patients referred to a major tertiary center during the February 6,2023 twin earthquakes in Türkiye.METHODS With the approval of the institutional ethics committee,1216 examinations of 238 patients transferred from the region to a tertiary major hospital after the twin earthquakes of February 6,2023,were retrospectively analyzed for spine injuries.RESULTS Spine computed tomography(CT)scans were performed in 192 of 238 patients with a suspected spinal injury,42 of whom also had an magnetic resonance imaging(MRI).In 86 of 192 patients(44.79%;M:F=33:53)a spinal fracture was detected on CT and in 33 of 42 patients(78.57%;M:F=20:13)a spinal injury was found on MRI.Of the 86 patients in whom vertebral injury was detected,fractures were detected in the Denis-B group in 33,Denis-C in 4,Denis-D in 20 and Denis-E in 11 patients.Among the vertebral bodies:40"compression fractures",17"burst fractures",5"translational dislocation fractures",5"flexion-distraction fractures"and 58"prolonged forced fetal posture fractures"were detected.In addition,isolated transverse or spinous process fractures were found in eighteen vertebrae.CONCLUSION Our study highlights the prevalence and diverse spectrum of spinal injuries following the February 6,2023 twin earthquakes in Turkey underscoring the urgent need for effective management strategies in similar disaster scenarios,and emphasizing the"prolonged forced fetal posture"damage we encountered in earthquake victims who remained under the collapse for a long time.

Management of Traumatic Brain Injuries at the Kara Regional Hospital

Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.

College Students’Cognition of Internet Accidental Injury Insurance:A Case Study of Guangdong Province

To explore college students'understanding and satisfaction of internet accidental injury insurance,and to analyse the factors influencing college students'awareness and satisfaction of internet accidental injury insurance.836 college students in Guangdong Province were selected by stratified random sampling.They were investigated with the self-designed questionnaire"College Students'Cognition of Internet Accidental Injury Insurance(CSCIAII)".29.67%,52.18%,10.13%and 8.02%of the college students didn't know,knew a little,knew relatively well and knew very well about internet accidental injury insurance,respectively.The percentage of college students who were very satisfied with the internet accidental injury insurance,thought the internet accidental injury insurance basically met their own needs,think it was acceptable but needed to be improved,did not agree with and were not satisfied with it at all were 9.55%,16.82%,47.73%,11.82%and 14.09%,respectively.College Students’awareness of insurance is weak,and they do not pay enough attention to accidental injury insurance.The design,publicity and sale strategies of internet insurance products may be important factors affecting college students'understanding and satisfaction with internet accidental injury insurance.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.

BRAIN INJURY BIOMECHANICS IN REAL WORLD VEHICLE ACCIDENT USING MATHEMATICAL MODELS

This paper aims at investigating brain injury mechanisms and predicting head injuries in real world accidents. For this purpose, a 3D human head finite element model （HBM-head） was developed based on head-brain anatomy. The HBM head model was validated with two experimental tests. Then the head finite element（FE） model and a multi-body system （MBS） model were used to carry out reconstructions of real world vehicle-pedestrian accidents and brain injuries. The MBS models were used for calculating the head impact conditions in vehicle impacts. The HBM-head model was used for calculating the injury related physical parameters, such as intracranial pressure, stress, and strain. The calculated intracranial pressure and strain distribution were correlated with the injury outcomes observed from accidents. It is shown that this model can predict the intracranial biomechanical response and calculate the injury related physical parameters. The head FE model has good biofidelity and will be a valuable tool for the study of injury mechanisms and the tolerance level of the brain.

Traumatic Brain Injury and Cerebral Vascular Accident: Application of Rasch Analysis to Examine Differences in Disability and Outcome in Post-Hospital Rehabilitation

The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly, Rasch Analysis accurately produced unique disability profiles that differentiated the treatment groups. This unique statistical technique offers a promising prescriptive hierarchical model for guiding neurological rehabilitation treatment.

学龄前儿童意外伤害流行特征分析与医疗费用比较

目的 探讨银川市1 156例学龄前儿童因意外伤害急诊住院患儿的流行特征,进一步掌握预防儿童意外伤害的基本方法。方法 本研究采用问卷调查方法,收集学龄前儿童因意外伤害急诊住院患儿病例的性别、年龄、伤害类型、住院费用、医保类型等资料。结果 1 156例学龄前儿童急诊住院患儿中男性病例702人(60.73%),女性病例454人(39.27%),男性明显多于女性。学龄前儿童急诊住院患儿年龄段主要在1~2岁,占比24.57%,意外伤害类型以烧烫伤最多(27.08%)。意外伤害类型为烧烫伤患儿的住院总费用花费最多(P<0.05)。结论 银川市学龄前儿童因意外伤害急诊住院患儿跟性别、年龄、伤害类型等有关,住院总花费跟意外伤害类型有关,故应针对人群特点开展有针对性地干预,预防伤害的发生。

Parametric analysis of craniocerebral injury mechanism in pedestrian trafficaccidents based on finite element methods

Purpose:The toughest challenge in pedestrian traffic accident identification lies in ascertaining injurymanners.This study aimed to systematically simulate and parameterize 3 types of craniocerebral injuryincluding impact injury,fall injury,and run-over injury,to compare the injury response outcomes ofdifferent injury manners.Methods:Based on the total human model for safety(THUMS)and its enhanced human model THUMShollow structures,a total of 84 simulations with 3 injury manners,different loading directions,andloading velocities were conducted.Von Mises stress,intracranial pressure,maximum principal strain,cumulative strain damage measure,shear stress,and cranial strain were employed to analyze the injuryresponse of all areas of the brain.To examine the association between injury conditions and injuryconsequences,correlation analysis,principal component analysis,linear regression,and stepwise linearregression were utilized.Results:There is a significant correlation observed between each criterion of skull and brain injury(p<0.01 in all Pearson correlation analysis results).A 2-phase increase of cranio-cerebral stress andstrain as impact speed increases.In high-speed impact(>40 km/h),the Von Mises stress on the skull waswith a high possibility exceed the threshold for skull fracture(100 MPa).When falling and makingtemporal and occipital contact with the ground,the opposite side of the impacted area experienceshigher frequency stress concentration than contact at other conditions.Run-over injuries tend to have amore comprehensive craniocerebral injury,with greater overall deformation due to more adequate kinetic energy conduction.The mean value of maximum principal strain of brain and Von Mises stress ofcranium at run-over condition are 1.39 and 403.8 MPa,while they were 1.31,94.11 MPa and 0.64,120.5 MPa for the impact and fall conditions,respectively.The impact velocity also plays a significant rolein craniocerebral injury in impact and fall loading conditions(the p of all F-test<0.05).A regressionequation of the craniocerebral injury manners in pedestrian accidents was established.Conclusion:The study distinguished the craniocerebral injuries caused in different manners,elucidatedthe biomechanical mechanisms of craniocerebral injury,and provided a biomechanical foundation forthe identification of craniocerebral injury in legal contexts.

Risk factors and predictive model of cerebral edema after road traffic accidents-related traumatic brain injury

Purpose:Cerebral edema(CE)is the main secondary injury following traumatic brain injury(TBI)caused by road traffic accidents(RTAs).It is challenging to be predicted timely.In this study,we aimed to develop a prediction model for CE by identifying its risk factors and comparing the timing of edema occurrence in TBI patients with varying levels of injuries.Methods:This case-control study included 218 patients with TBI caused by RTAs.The cohort was divided into CE and non-CE groups,according to CT results within 7 days.Demographic data,imaging data,and clinical data were collected and analyzed.Quantitative variables that follow normal distribution were presented as mean±standard deviation,those that do not follow normal distribution were presented as median(Q1,Q3).Categorical variables were expressed as percentages.The Chi-square test and logistic regression analysis were used to identify risk factors for CE.Logistic curve fitting was performed to predict the time to secondary CE in TBI patients with different levels of injuries.The efficacy of the model was evaluated using the receiver operator characteristic curve.Results:According to the study,almost half(47.3%)of the patients were found to have CE.The risk factors associated with CE were bilateral frontal lobe contusion,unilateral frontal lobe contusion,cerebral contusion,subarachnoid hemorrhage,and abbreviated injury scale(AIS).The odds ratio values for these factors were 7.27(95%confidence interval(CI):2.08-25.42,p=0.002),2.85(95%CI:1.11-7.31,p=0.030),2.62(95%CI:1.12-6.13,p=0.027),2.44(95%CI:1.25-4.76,p=0.009),and 1.5(95%CI:1.10-2.04,p=0.009),respectively.We also observed that patients with mild/moderate TBI(AIS≤3)had a 50%probability of developing CE 19.7 h after injury(χ^(2)=13.82,adjusted R2=0.51),while patients with severe TBI(AIS>3)developed CE after 12.5 h(χ^(2)=18.48,adjusted R2=0.54).Finally,we conducted a receiver operator characteristic curve analysis of CE time,which showed an area under the curve of 0.744 and 0.672 for severe and mild/moderate TBI,respectively.Conclusion:Our study found that the onset of CE in individuals with TBI resulting from RTAs was correlated with the severity of the injury.Specifically,those with more severe injuries experienced an earlier onset of CE.These findings suggest that there is a critical time window for clinical intervention in cases of CE secondary to TBI.

463例PICU意外伤害患儿的病因及临床特点

目的探讨463例儿童重症监护室(PICU)意外伤害患儿的病因及临床特点。方法选取贵阳市某三甲医院PICU收治的意外伤害患儿463例为研究对象,根据国际疾病分类法(ICD-10)将所有患儿意外伤害病因分为跌落、交通事故、中毒、误吸、火灾及烧伤、烫伤、外伤、溺水、动物咬伤及腐蚀伤共10类,收集患儿的一般资料(年龄、性别、家庭住址及发病时间)、临床资料(治疗方式、是否接受机械通气、小儿危重病例评分、住院时间及住院费用)及预后情况(治愈、好转、自行出院及死亡,其中治愈、好转视为预后良好,自行出院、死亡视为预后不良),采用单因素方差分析和χ2检验分析患儿的病因和临床特点。结果PICU意外伤害患儿中以男性、婴幼儿、农村儿童多见,但仅年龄差异有统计学意义(P<0.05);在各类型意外伤害中,交通事故、跌落伤患儿的发病率、死亡率、住院日及治疗费用均居于前列;各类意外伤害在儿童危重病例评分、呼吸机使用及住院负担上的差异具有统计学意义(P<0.05)。结论PICU意外伤害患儿中男性、婴幼儿期、农村患儿居多,跌落伤、交通事故在发病率、死亡率及疾病负担中居于前列,儿童危重病例评分可为预后提供评价依据。

原花青素对低体温致小鼠急性肺损伤的保护作用及机制研究

目的探索原花青素对重度意外性低体温致小鼠急性肺损伤的保护作用及机制。方法将45只小鼠分为空白组(CON组,n=15)、模型组(CE组,n=15)和干预组(CE+PCs组,n=15)。CON组和CE组10 ml/kg蒸馏水灌胃7 d,CE+PCs组采用500 mg/kg原花青素灌胃7 d,CE组及CE+PCs组在第8天建立重度意外性低体温致小鼠肺损伤模型后处死。观察各组小鼠肺组织大体改变,肺组织病理学改变并进行肺损伤评分;计算肺组织湿干比;ELISA法检测肺组织匀浆中TNF-α及IL-6的浓度;蛋白免疫印迹法检测肺组织TLR4、NFκB-P65及IκBα表达。结果CE组小鼠肺损伤评分高于CON组;CE+PCs组小鼠肺损伤评分低于CE组;CE组小鼠肺湿干比高于CON组;CE+PCs组小鼠肺湿干比低于CE组;CE+PCs组小鼠肺损伤评分低于CE组;CE组小鼠肺组织匀浆中的TNF-α和IL-6浓度高于CON组;CE+PCs组小鼠肺组织匀浆中TNF-α和IL-6浓度低于CE组;CE组小鼠肺组织中TLR4及NFκB-P65表达均高于CON组,IκBα表达低于CON组;CE+PCs组小鼠肺组织中TLR4及NFκB-P65表达低于CE组,IκBα表达水平高于CE组,差异均有统计学意义(P<0.05)。结论重度意外性低体温可导致小鼠急性肺损伤,该过程可能与炎症通路的激活有关。原花青素可能通过抑制TLR4/NFκB通路减少炎症反应来保护重度意外性低体温诱导的急性肺损伤。

运动员参保体育保险必要性与重要性的再认识

运动员参保体育保险是运动员职业生涯发展的重要保障,运动员职业与其他岗位职业的工作内容有所不同,运动员在个人职业发展中将会面临各种风险,需要对体育保险进行更加全方位的认识。该研究运用文献资料法、逻辑分析法,结合现有文献对运动员参保体育保险的必要性与重要性进行了系统分析,研究认为,体育保险主要分为社会保障保险、商业保险、伤残互助保险三大类;运动员职业生涯的各种风险迫使运动员必须参保体育保险;参保体育保险对运动员职业生涯的延续、社会保障、职业保障以及运动风险管理具有重要意义。该文就如何提升运动员的体育保险参保意识提出了相应的解决措施。

甘肃省平凉市877名小学生焦虑情绪现况调查

目的了解小学生焦虑情绪现状,为有针对性地开展心理健康教育干预提供参考依据。方法于2023年4月11—14日采用方便抽样和整群抽样方法选取甘肃省平凉市2所小学4~6年级的900名小学生为研究对象,以班级为单位进行问卷调查,收集小学生一般情况、家庭情况、伤害情况、心理状态等信息。以儿童焦虑量表评估小学生焦虑情绪得分情况,分析比较不同特征被调查小学生焦虑情绪检出率和焦虑情绪得分。结果根据问卷有效回收情况,共调查小学生877名。被调查小学生焦虑情绪检出率为21.2%,具有留守、有意外伤害发生经历、独生子女、女生、同代监护特征的小学生焦虑情绪检出率较高(均P<0.05)。对不同特征小学生焦虑量表得分进行比较发现,留守小学生焦虑情绪总得分、各维度得分均高于非留守小学生(均P<0.05);有意外伤害发生经历的小学生焦虑情绪总得分、各维度得分均高于无意外伤害发生经历的小学生(均P<0.05);独生子女焦虑情绪总得分,以及社交焦虑、分离焦虑、恐慌障碍得分均高于非独生子女(均P<0.05);女生焦虑情绪总得分,以及分离焦虑、广泛性焦虑、恐慌障碍、躯体伤害恐惧得分均高于男生(均P<0.05);同代监护小学生焦虑情绪总得分,以及社交焦虑、分离焦虑、恐慌障碍、躯体伤害恐惧得分均高于其他监护类型小学生(均P<0.05)。结论小学生焦虑情绪的发生与是否经历过意外伤害、留守、独生子女、性别及监护类型有关。在小学生焦虑情绪预防中应主要注重家校协同,尤其是对留守且有意外伤害发生经历的小学生应给予更多关注。

儿童意外伤害的影响因素的研究进展

意外伤害为儿童致伤、致残甚至致死的主要原因,已经成为备受关注的公共卫生问题。儿童因年龄和发展阶段的特殊性,更容易受到意外伤害。本文从家庭、学校、公共场所以及社会经济因素四方面分析其对儿童意外伤害的影响,认为预防和减少儿童意外伤害需要政府、家庭、学校、社区和社会各界的共同努力,形成合力,以更好地确保儿童的安全成长。

Comparative numerical study on the child head injury under different child safety seat angles

It has been shown that annually around 1250 children younger than 15 years old die in traffic accident.The number of children who also injured as a consequence of car accidents is noticeably higher.According to the ECE-R44 regulation the safety of children in the cars,the use of a child safety seat(CSS)is highly recommended.Using a CSS would dramatically diminish the injuries of traffic accidents.However,the posture,especially the angle,of a child when seating on a seat may also affect the amount of injury occurs during the accident.It has been revealed that during the accident only few children remained seated in the standard position,and most of them whether slouched or slanted and turned their head to the side-support of the CSS.Extreme positions,such as leaning forward,escaping from the harness or holding feet were also observed.This study aimed to perform a finite element(FE)study to figure out what angle of seating would result in the least amount of injury to the child head in a typical car crash under the speed of 47 km/h.To do that,a 1.5 years old child dummy(a dummy representing the anthropometry of a 1.5 years old child)has been accommodated on a seat under the angles of 15°,30°,and 45°.The results revealed.The resulted displacements in the head after the accident were also calculated at X,Y,and Z directions.The results in this regard indicated a higher displacement at X direction whereas the lowest one was seen at Y direction.The results have implications not only for understanding the amount of injury to the child head after the accident under different seating angles,but also for giving an insight to the CSS industries and families to choose the right seating posture for the child in the car to reduce the severity of injury.

Trends in Injury-related Incidence and Mortality Among Inpatients in Guangdong Province in 1997-2001

Objective Currently, China is in short of thorough and systemic data concerning the patterns and incidence of injuries and related deaths. Guangdong Province as one of the economically advanced areas in China is faced with a relatively serious injury problem, and investigation of this problem in this Province will provide valuable information for other provinces and areas in this Country, as well as scientific basis for policy making for injury prevention and control. Methods Analyses are based on the computerized hospital discharge data collected from 322 hospitals in Guangdong Province between 1997 and 2001. Diagnoses are coded according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Results The total hospitalization rate related with injuries increased year by year from 1997 to 2001. The ratio of case-fatality has a decline trend for all injury inpatients, who were mainly caused by motor vehicle accidents, unintentional falls, puncture and cut by machine and others. The constituent ratio of death among patients caused by motor vehicle accidents accounted for 56.13% among the total deaths, which ranked as the first place. The direct medical cost also had an increased trend. Conclusions Data on injuries requiring hospitalization can be used to design and target more effective injury prevention programs. Injury prevention would decrease human sufferings, disability, and associated economic losses.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

Socio-Demographic Profile of Adults Admitted in Emergency for Brain Trauma Injuries at the University Hospital of Brazzaville (Congo)

The aim of this study was to evaluate socio-demographic profile of adults admitted in emergency for Traumatic Brain Injury (TBI) at the University Hospital of Brazzaville in the Republic of Congo. We performed a prospective study within a period of six months, into the surgical unit of the emergency department of the University Hospital of Brazzaville. A total of 2617 patients were recorded, among which 268 cases were TBI (10.25%) where 142 cases were sampled in our series. The average age was 36.7 ± 16.6 years. The sex ratio was 6.1. The TBI was mainly due to road accident in 121 cases (85.2%) described as follows: motorcycle accident about 48 cases (39.7%) and the pedestrian’s injuries about 42 (34.8%). In the majority of the cases, cautions were not taken by the drivers;during the case of the motorcycle accident, about 97.9% of the riders did not wear a helmet. The TBI remains a growing public health concern in the low-income countries, like in Africa. Measurements on the road traffic regulation are to be strengthened to reduce the growth of this silent epidemic.

2017—2021年广西5岁以下儿童意外死亡情况分析

目的:分析2017—2021年广西5岁以下儿童意外死亡情况,为降低广西5岁以下儿童意外死亡率提供参考依据。方法:利用广西“桂妇儿健康服务信息管理系统”收集2017—2021年广西5岁以下儿童死亡报告卡和广西妇幼卫生年报数据,分析广西5岁以下儿童意外死亡原因、死亡率及变化趋势。结果:2017—2021年广西5岁以下儿童因意外伤害死亡3212人,意外死亡率为105.46/10万,意外死亡占5岁以下儿童死亡的22.77%。其中,农村儿童意外死亡率(109.64/10万)高于城市儿童(96.46/10万),1~4岁儿童(69.05/10万)意外死亡率高于婴儿(36.41/10万),男童意外死亡率(118.20/10万)高于女童(91.03/10万)。意外死亡构成比的分析结果显示,意外死亡儿童中,70.98%为农村儿童,65.47%为1~4岁儿童,59.43%为男童。意外死因排名中,意外窒息排在第1位,占35.74%,主要发生在婴儿期;溺水、交通意外分别排在第2、3位,占比分别为28.64%和14.04%,主要发生在1~4岁儿童。结论:意外死亡仍是广西5岁以下儿童死亡的主要死因,2017—2021年5岁以下儿童意外死亡率无明显变化,<3岁儿童、农村儿童、男童是意外伤害预防的重点人群,应针对不同年龄儿童制定相应的防范措施,降低儿童意外死亡率。

Severe Trauma of Uterus and the Right Limb during a Road Accident at the Department of Obstetrics and Gynecology of the Teaching Hospital Souro Sanou of Bobo-Dioulasso: A Case Report and Review of Literature

The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right limb injuries during a serious road accident. Aim: the aim is to show the increasing of road accident with the motorized tricycle and their many risks for pregnant woman. Case Presentation: our patient was thrown from the back cargo of a motorized tricycle (three-wheeled vehicle) after a collision with a truck in a rural area from 150 km to Bobo-Dioulasso. She sustained a closed abdominal injury and a severe right lower limb open injury. At admission in our department in the Teaching Hospital, she was conscious, shocked with hemodynamic instability, including low blood pressure (75/52 mmHg), rapid heart rate (140 pulses per minute), rapid breath rate (40 per minute), and cold extremities. Abdominal examination was painful with uterine hypertonia, 28 cm height uterus, and no fetal heart heartbeat. A laparotomy in urgency revealed a rupture of the uterus fundus with a dead fetus. A conservative surgical treatment was performed. An open trauma to the right limb was managed by the orthopedists with a good outcome. Conclusion: Accident trauma during pregnancy is becoming more and more frequent with the increase in means of transport in urban and inter urban areas. The transport ways of the pregnant woman must take into account her safety and that of the fetus.