Impact of lockdown policies during the COVID-19 outbreak on a trauma center of a tertiary hospital in China

BACKGROUND Coronavirus disease 2019(COVID-19)is a major and costly public health emergency.AIM To investigate the impact of China’s lockdown policies during the COVID-19 outbreak on the level I trauma center of a tertiary comprehensive hospital of Traditional Chinese Medicine.METHODS All patients admitted to our trauma center during a lockdown in 2020 and the same period in 2019 were enrolled.We collected data on demographics,daily visits,injury type,injury mechanism,injury severity score,and patient management for comparative analysis.RESULTS The total number of patients in the trauma center of our hospital decreased by 50.38%during the COVID-19 Lockdown in 2020 compared to the same period in 2019.The average number of trauma visits per day in 2019 was 47.94,compared to 23.79 in 2020.Comparing the patients’demographic data,loss of employment was the most predominate characteristic in 2020 compared to 2019,while there was no significant difference in gender,age,and marital status between both periods.During the lockdown period,the proportion of traffic accident-related injuries,injuries due to falls greater than 1.5 m,and mechanical injuries decreased significantly,whereas the proportion of injuries caused by falls less than 1.5 m,cuts,assault,bites,and suicidal tendencies and other injuries increased relatively.In addition,the proportion of patients with minor injuries increased and serious injuries decreased during the lockdown.The hospitalization rate increased significantly,and there was no significant difference in emergency surgery and death rates.CONCLUSION The lockdown policies during the COVID-19 outbreak significantly altered the number and mechanism of traumatic events in our hospital,which can be monitored regularly.Our results suggest that mandatory public health prevention and control measures by the government can reduce the incidence of traumatic events and the severity of traumatic injuries.Emergency surgery and mortality rates remain high,increased because of factors such as family injury and penetrating injury,and hospitalization rates have increased significantly.Therefore,our trauma center still needs to be fully staffed.Finally,from the perspective of the injury mechanism,indoor trauma is a major risk during a lockdown,and it is particularly important to develop prevention strategies for such trauma to reduce the medical burden of the next catastrophic epidemic.

创伤后深静脉血栓形成遗传危险因素的全基因组关联分析

目的探究创伤后深静脉血栓形成(DVT)的遗传危险因素。方法采用巢式病例对照研究。纳入50名创伤性下肢骨折后发生DVT患者和50名未发生DVT患者,两组患者的性别、年龄、骨折部位相匹配。创伤患者于术前行静脉造影检查以诊断是否发生DVT。应用全基因组关联分析(GWAS)筛选创伤性下肢骨折后术前DVT的遗传危险因素。用于GWAS的基因组DNA从白细胞中提取。结果应用GWAS评估144个兴趣基因,包含2662个单核苷酸变异(SNV),与表型之间的相关性。共发现10个基因与创伤后DVT发生显著相关:止血机制辅因子,包括THBD、F5、SERPIND1、ITGA2,维生素K依赖(VKD)羧化相关因子,包括GGCX、CALU,细胞色素P450家族成员,包括CYP1A1、CYP3A4、CYP2C19、CYP2B6。结论创伤性下肢骨折后DVT可能受止血机制辅因子、VKD羧化相关因子和细胞色素P450家族成员的调控。

2013年-2021年13313例急诊抢救室创伤患者流行病学特征调查:单中心回顾性研究

目的 分析急诊抢救室内创伤患者的流行病学特征,为创伤的预防和救治提供依据。方法 回顾性分析2013年1月—2021年12月急诊抢救室收治创伤患者的性别、年龄、就诊时间、神志、血压、心率、滞留情况、患者转归及其预后等临床资料。结果 急诊抢救室共收治13 313例患者,男女比为2.5∶1。以中青年患者居多,共8 518人,占63.98%。抢救室收治患者月高峰出现在7、9、10月,时间高峰出现在11:00~21:00。创伤患者抢救室滞留时间呈延长趋势,73.2%患者在急诊抢救室滞留>3 h。随着年龄的增长,在急诊抢救室滞留>3 h的患者比例逐渐增高。抢救室收治的创伤患者中,死亡345例(2.6%),手术治疗4 035例(30.3%),转入专科病区保守治疗5 082例(38.2%),急诊留观2 272例(17.1%),抢救后出院的患者1 579例(11.9%)。多因素Logistic分析结果表明,入院时意识为非清醒、收缩压<110 mmHg、舒张压异常、心率异常是引起严重创伤患者死亡的危险因素。结论 急诊科应根据创伤患者主要人群、创伤发生的高峰时段、高峰季节合理配备医疗资源,规范急诊流程,急诊医护人员应重视对患者意识和生命体征的评估,并给予积极处理。

Ocular Trauma in a Rural Population of North China:The Handan Eye Study

Objective To determine the prevalence of ocular trauma and the proportion of blindness and visua impairment due to trauma in a rural population in northern China. Methods The Handan Eye Study is a population-based cross-sectional study that surveyed 6830 Chinese people aged 30＋ years from 13 randomly selected villages in Yongnian County, city of Handan, Hebei Province, in July, 2006. All participants underwent a standardized interview and extensive examinations. A structured questionnaire was used to collect information on ocular trauma. Results Of the 5837 participants who filled out the questionnaire, 124 subjects [2.1%; 95% confidence interval （CI）, 1.8%-2.5%] reported a history of ocular trauma in either eye, including 19 （0.3%） persons reporting trauma in both eyes. Men were more likely to have an eye injury than women [odds ratio （OR）, 3.3; 2.2-4.9]. In multiple logistic regression models, ocular trauma was significantly more frequent among normotensive participants when compared with hypertensive participants （hypertensive vs. normotensive＂ OR, 0.6; 0.4-0.9） and among participants who had a history of falls （OR, 2.4; 1.2-4.8）. The proportion of unilateral visual impairment and unilateral blindness due to trauma were 10.5% （13 subjects） and 21.0% （26 subjects）, respectively. Conclusion Our study reports the prevalence of severe ocular trauma among adults in rural China, revealing a high proportion of blindness and visual impairment due to trauma. These findings suggest the need for educational strategies to increase eye health awareness in this rural population with focus on providing at least appropriate first aid care to reduce blindness due to trauma.

Diagnosis and management of colonic injuries following blunt trauma

AIM: To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma. METHODS: A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods, associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed. RESULTS: Colonic injuries were caused mainly by motor vehicle accidents. Of the 82 patients, 58 (70.3%) had other associated injuries. Laparotomy was performed within 6 h after injury in 69 cases (84.1%), laparoscopy in 3 because of haemodynamic instability. The most commonly injured site was located in the transverse colon. The mean colon injury scale score was 2.8. The degree of faecal contamination was classified as mild in 18 (22.0%), moderate in 42 (51.2%), severe in 14 (17.1%), and unknown in 8 (9.8%) cases. Sixty-seven patients (81.7%) were treated with primary repair or resection and anastomosis. Faecal stream diversion was performed in 15 cases (18.3%). The overall mortality rate was 6.1%. The incidence of colonic injury- related abdominal complications was 20.7%. The only independent predictor of complications was the degree of peritoneal faecal contamination (P = 0.02). CONCLUSION: Colonic injuries following blunt trauma are especially important because of the severity and complexity of associated injuries. A thorough physical examination and a combination of tests can be used to evaluate the indications for laparotomy. One stage management at the time of initial exploration is mostoften used for colonic injuries.

Cross-sectional study of the educational background and trauma knowledge of trainees in the “China trauma care training” program

Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.

Traumatic brain injury and palliative care:a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey

Traumatic brain injury（TBI）,which is seen more in young adults,affects both patients and their families.The need for palliative care in TBI and the limits of the care requirement are not clear.The aim of this study was to investigate the length of stay in the palliative care center（PCC）,Turkey,the status of patients at discharge,and the need for palliative care in patients with TBI.The medical records of 49 patients with TBI receiving palliative care in PCC during 2013–2016 were retrospectively collected,including age and gender of patients,the length of stay in PCC,the cause of TBI,diagnosis,Glasgow Coma Scale score,Glas gow Outcome Scale score,Karnofsky Performance Status score,mobilization status,nutrition route（oral,percutaneous endoscopic gastrostomy）,pressure ulcers,and discharge status.These patients were aged 45.4 ± 20.2 years.The median length of stay in the PCC was 34.0 days.These included TBI patients had a Glasg ow Coma Scale score ≤ 8,were not mobilized,received tracheostomy and percutaneous endoscopic gastrostomy nutrition,and had pressure ulcers.No difference was found between those who were discharged to their home or other places（rehabilitation centre,intensive care unit and death） in respect of mobilization,percutaneous endoscopic gastrostomy,tracheostomy and pressure ulcers.TBI patients who were followed up in PCC were determined to be relatively young patients（45.4 ± 20.2 years） with mobilization and nutrition problems and pressure ulcer formation.As TBI patients have complex health conditions that require palliative care from the time of admittance to intensive care unit,provision of palliative care services should be integrated with clinical applications.

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

Background: This study reports a 10-year retrospective analysis of multiple trauma complicated by pulmonary contusion. The purpose of this study is to ascertain the risk factors for mortality due to trauma in patients with pulmonary contusion, the impact of various treatment options for prognosis, and the risk factors for concurrent Acute Respiratory Distress Syndrome(ARDS). Methods: We retrospectively analyzed 252 trauma patients with lung contusion admitted to the General Hospital of Guangzhou Military Command from January 2000 to June 2011 by using the statistical processing system SPSS 17.0 for Windows. Results: We included 252 patients in our study, including 214 males and 38 females. The average age was 37.1±14.9 years. There were 110 cases admitted to the ICU, of which 26 cases with ARDS. Nine of the 252 patients died. We compared those who survived with those who died by gender and age, the difference was not statistically significant(P=0.199, P=0.200). Separate univariate analysis of those who died and those who survived found that shock on admission(P=0.000), coagulation disorders(P=0.000), gastrointestinal bleeding(P=0.02), the need for emergency surgery on admission(P=0.000), pre-hospital intubation(P=0.000), blood transfusion within 24 hours(P=0.006), the use of mechanical ventilation(P=0.000), and concurrent ARDS(P=0.000) are poor prognosis risk factors. Further logistic analysis, including the admission GCS score(OR=0.708, 95%CI 0.516-0.971, P=0.032), ISS score(OR 1.135, 95%CI 1.006-1.280, P=0.039), and concurrent ARDS(OR=15.814, 95%CI 1.819-137.480, P=0.012), identified the GCS score, ISS score and concurrent ARDS as independent risk factors of poor prognosis. Shock(OR=9.121, 95%CI 0.857-97.060, P=0.067) was also related to poor prognosis. Patients with injury factors such as road accident, falling injury, blunt injury and crush injury, et al.(P=0.039), infection(P=0.005), shock(P=0.004), coagulation disorders(P=0.006), emergency surgery(P=0.01), pre-hospital intubation(P=0.000), chest tube insertion(P=0.004), blood transfusion(P=0.000), usage of hormones(P=0.002), phlegm(P=0.000), ventilation(P=0.000) were at a significantly increased risk for ARDS complications. Conclusions: Those patients with multiple trauma and pulmonary contusion admitted to the hospital with shock, coagulopathy, a need for emergency surgery, pre-hospital intubation, and a need for mechanical ventilation could have a significantly increased risk of mortality and ARDS incidence. A risk for poor prognosis was associated with gastrointestinal bleeding. A high ISS score, high APACHE Ⅱ, and low GCS score were independent risk factors for poor prognosis. If patients developed an infection or were given drainage, hormones, and phlegm treatment, they were at higher risk of ARDS. Pre-hospital intubation and drainage were independent risk factors for ARDS. In patients with ARDS, the ICU stay, total length of stay, and hospital costs might increase significantly. A GCS score【5.5, APACHE Ⅱ score】16.5, and ISS score】20.5 could be considered indicators of poor prognosis for patients with multiple trauma and lung contusion.

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury:A cross-sectional survey

This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury(STBI)in China and analysis the differences and their causes.Methods A cross-sectional survey was conducted.From December 2019 to January 2020,ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI.The questionnaire included two parts:the general information of participants(10 items)and application of preventive measures for feeding intolerance in STBI patients(18 items).Results Totally 996 nurses and physicians completed the questionnaire.Among various methods,gastrointestinal symptoms(85.0%)and injury severity(71.4%)were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients,respectively.Initiating enteral nutrition(EN)within 24–48 h(61.5%),nasogastric tubes(91.2%),30°–45°of head-of-bed elevation(89.5%),continuous feeding by pump(72.9%),EN solution temperature of 38–40°C(65.5%),<500 ml initial volume of EN solution(50.0%),monitoring gastric residual volume with a syringe(93.7%),and assessing gastric residual volume every 4 h(51.5%)were mostly applied for EN delivery among STBI patients.Prokinetic agents(73.3%),enema(73.6%),probiotics(79.0%),antacid agents(84.1%),and non-nutritional preparations as initial EN formula(65.6%)were commonly used for preventing feeding intolerance among STBI patients.Conclusions The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance.However,some effective new technologies and methods have not been timely applied in clinical practice.We suggest that managers,researchers,clinicians,nurses,and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.

Healing the Trauma of Sethe:A Psychological Study on Toni Morrison's Beloved

Beloved is one of Toni Morrison’s most famous novels and attracts much attention from the public.This essay aims to analyze the healing process of Sethe’s trauma from the perspective of psychological analysis.There are four parts.First,it introduces the plot of the story and the theory.The second part analyzes the forming of Sethe’s trauma and the third part discusses the healing process.The last part reaches the conclusion.By analyzing Sethe’s trauma from psychoanalysis,this paper aims to help these black people to reconstruct their identity and achieve renascence.

Maxillofacial Trauma at LOMÉ(TOGO): About 501 Cases

Objective: We conducted a retrospective study to determine the epidemiological profile and describe the diagnostic aspects of maxillofacial trauma. Methods: It was a retrospective descriptive study over 20 years (January 1995-December 2014) in Oral and Maxillofacial Surgery Department of the Sylvanus Olympio Teaching Hospital in Lomé. All the hospitalized patients for facial trauma were included. Results: 501 cases of facial trauma were retained with an annual incidence of 25 cases. The average age was 33 years and the most represented age groups are those of 20 to 29 years (35.53%) and 30 to 39 years (30.14%);and the sex ratio was 9. Traffic roads accidents represented the main circumstance (89.81%) and the motorcycle was the most involved (80.34%). Patients were admitted in the first week (75.65%) with 35.93% on the first day. The maxillofacial CT-Scan was the most requested radiological examination (33.75%). Bone lesions were: mandible (31%), zygomatic (23.26%) and maxillary (18.99%). Dental lesions were found in 68 cases. Extra-facial lesions were found in 44 cases. The patients were treated in the first week (62.48%) and in the first day after admission (20.76%). Conclusions: Maxillofacial trauma is increasing, mainly in young adults due to road traffic accidents.

From Trauma to Recovery: An Interpretation of Singer’s Enemies: A Love Story

American Jewish writer Isaac Bashevis Singer’s Enemies:A Love Story explores the experience of Holocaust survivors in post-Holocaust America.The novel takes the entangled relationship between the protagonists as the primary developmental clue,mirroring the plights that the American Jewish immigrants have encountered in this new land of promise.Through the description of the living conditions of those Holocaust survivors in the post-Holocaust era,the novel reveals the catastrophic trauma of the Jewish individuals and the whole Jewish nation.This article delves into the psychological trauma of those Holocaust survivors,and explores the journey of recovery they are searching by a combined analysis of their traumatic experience and symptoms.By applying the trauma theory to interpret this novel,it is aimed not merely to depict the traumatized history of the Holocaust and its universe evil from a new perspective,but to remind the readers that history cannot be forgotten.

Care for a patient with hip trauma caused by a car accident: a case study

Objective:To summarize the wound care experience of a patient with hip trauma caused by a car accident.Methods:Under the guidance of the“TIME”principle,we uesd new dressings to treat contaminated wounds and observed,record the effect.Results:The initial dressing change for the pressure ulcer wound was on 2nd August,the red tissue was on the wound,and the wound area was about 16 cm×20 cm.We changed the dressing on 11th August,the color of the wound turned to pink,its area was about 13 cm×13 cm,and it was already healed at that time.Conclusion:Under the guidance of the“TIME”principle of wound management,the treatment of contaminated wounds with new dressing treatment was effective,which reduced the patient’s pain and improved the patient’s quality of life.

创伤与赋能:《接骨师之女》的失能书写

谭恩美在第四部小说《接骨师之女》中创造了一系列失能人物,从失能研究的角度解读该小说,可以再现失能与创伤之间的学术关联,从新的层面揭示小说的意义,并拓展创伤研究的实践维度。小说以三代女性的失能与创伤为主线:宝姨的失能与创伤理论中的失去相关联,再现了旧中国女性遭受的历史性创伤;茹灵在中国的工作和婚姻均为失能的隐喻,在美国的魔幻失能和创伤记忆的闪回则加重了她的创伤体验;露丝在美国社会的失能是种族创伤的体现,是健全主义与种族主义联手的结果。谭恩美在呈现失能与创伤之间的有机联系后,通过让失能的华裔美国后代从中华文化中汲取精神力量、从模范少数族裔的成功传统中获得身份认同的方法来为人物赋能,并治愈失能,彰显了作者对于中华文化的肯定态度。

402例牙外伤急诊患者临床分析

目的了解广州市部分牙外伤急诊患者临床情况,研究其临床特征,为临床工作和健康宣教提供数据支持。方法将2017年1月至2022年1月就诊于南方医科大学口腔医院综合急诊科、发生牙外伤患者的临床资料按照牙外伤患者的性别、年龄、外伤原因、外伤类型、牙位、外伤发生时间段、外伤后就诊时间等信息进行回顾性统计分析。结果所有患者牙外伤男女发生比例为1.07∶1;牙外伤好发年龄为10~19岁,该年龄段的男女比例为2.76∶1;对于牙外伤发生原因进行分析,发现摔伤和撞伤是主要原因。牙震荡和简单冠折是发生率最高的牙外伤亚类。牙外伤发生率最高的牙位是上颌中切牙,其次为上颌侧切牙。一月和十二月份是外伤发生率最高的两个月份,周末牙外伤就诊率略高于工作日。对于外伤后就诊时间的分析,发现77.81%的牙外伤患者于外伤后24 h内就诊。结论牙外伤好发于青少年上颌切牙,损伤类型多见于冠折、牙震荡,主要原因为摔伤和撞伤。群众应注意加强户外活动中牙齿的保护,学习应急处理的方法。同时口腔医师应熟练牙外伤的处理,对于不常见的牙外伤类型更应该进行诊断排查,以免遗漏。

犹太文学与大屠杀研究的跨学科探索——阿琳·艾欧纳斯库教授访谈录

阿琳·艾欧纳斯库是国际知名学者、文学批评家,现任上海交通大学长聘教授,国际学术期刊《词语与文本:文学研究与语言学》主编。她在现代主义文学、犹太大屠杀研究等方面著述丰富。本篇采访涉及艾欧纳斯库学术生涯中的几个不同研究领域,如英国文学、犹太文学、大屠杀与记忆研究等。她基于文学与大屠杀研究之间的联系,以及历史见证与代际传递在记忆研究中的重要作用,重点阐述了纪念伦理、后记忆、跨媒介性等概念。艾欧纳斯库还向中国学界提出了具有发展潜力的相关研究方向,以推动中外学者开展更为紧密的合作研究。

青少年抑郁障碍患者的早期创伤史研究

目的:了解抑郁障碍青少年遭受童年创伤情况。方法:分别对61例门诊抑郁障碍青少年家庭和57例正常学生家庭采用童年期创伤调查问卷、抑郁自评量表进行调查。结果:与对照组相比,抑郁青少年组病前有较多创伤史(分离、虐待等)(47.5%/19.3%,确切P=0.004.OR=3.79),有创伤经历的患者SDS评分较无创伤史的患者高(64.7±9.9/57.9±11.1,t=2.48,P=0.016)。结论:童年创伤与青少年抑郁障碍发病有关。

1420例颌面部创伤患者临床分析

目的:对1420例颌面创伤病例进行临床回顾分析。方法:对上海交通大学医学院附属第九人民医院2005-2006年间因颌面部创伤住院的1420例患者进行回顾分析,明确发病年龄、性别、致伤原因、骨折类型和伴发损伤。结果:1420例颌面创伤病例中,男女比例为3.24:1;21～30岁(36.22%)为发病的高峰年龄段;道路交通伤(42.07%)在致伤原因中居首位;颧骨(41.83%)和下颌骨(29.50%)为骨折高发部位;发生创伤超过3周后才获得治疗的病例占43.6%。结论:道路交通伤在目前仍为主要的致伤原因,颧骨和下颌骨为最常见的创伤部位,有相当比例的病例因治疗不及时以及治疗不当造成牙颌面畸形,值得引起注意。

急性颅脑损伤后进展性出血性损伤高危因素分析

目的探讨急性颅脑损伤后进展性出血性损伤(PHI)相关的高危因素,为临床判断和预防提供依据。方法回顾性分析该科收治的398例闭合性颅脑损伤住院患者的临床资料,按是否发生PHI分为进展组和非进展组。结果单因素分析显示,患者年龄、性别比、受伤到首次CT时间、入院格拉斯哥昏迷(GCS)评分、平均动脉压、合并颅骨骨折、合并硬膜外血肿、合并脑挫伤、合并蛛网膜下腔出血、双侧伤、意识障碍、瞳孔扩大、首次CT颅内血肿量大于10mL、首次CT血肿量、首次复查CT血肿量、两次CT血肿量差、血小板、血浆纤维蛋白水平、D-二聚体水平、住院总CT数、总住院天数为影响因素(P<0.05)。多因素分析显示,受伤到首次CT时间、GCS<12分、意识障碍、瞳孔扩大、首次CT颅内血肿量大于10mL、合并脑挫伤、合并蛛网膜下腔出血、血小板、D-二聚体水平为PHI的独立危险因素(P<0.05)。结论急性颅脑损伤患者应及时进行头颅CT检查,对GCS<12分、意识障碍、瞳孔扩大、首次CT颅内血肿度大于10mL、合并脑挫伤、合并蛛网膜下腔出血、血小板和D-二聚体水平异常的患者,应密切观察病情进展,尽早定时复查头颅CT。

交通伤颌面骨折临床病例回顾性研究

本文对西安第四军医大学口腔医院１０年间５８１名交通事故颌面骨折住院患者进行了临床流行病学回顾性研究。男女发病人数比例为４．３∶１，发病年龄高峰为２０～３０岁，交通事故是颌面骨折的首要原因，占４７．４３％。颌面部交通伤以多发性骨折为主，人均骨折部位１．９处。下颌骨最易发生骨折，其次是颧骨和上颌骨。在致伤原因中，交通伤颌面骨折严重程度最大，且合并其他部位损伤最多，颅脑合并伤的发生率为４８．５％，居于首位。