中国全科医学 ›› 2023, Vol. 26 ›› Issue (26): 3282-3289.DOI: 10.12114/j.issn.1007-9572.2023.0024

• 论著·人群健康研究·儿童健康 • 上一篇    下一篇

15 773例儿童非故意伤害特征研究

沈裕, 陈健, 寿铁军, 俞蓓蓉*()   

  1. 315000 浙江省宁波市妇女儿童医院儿科
  • 收稿日期:2022-09-06 修回日期:2023-03-27 出版日期:2023-09-15 发布日期:2023-04-06
  • 通讯作者: 俞蓓蓉

  • 作者贡献:沈裕提出研究思路,设计研究方案,撰写论文;陈健进行数据收集与整理、统计学处理;寿铁军对结果进行分析与解释;俞蓓蓉负责文章的质量控制及审校,对文章整体负责,监督管理。
  • 基金资助:
    浙江省医药卫生科技计划项目(2021KY1053); 宁波市重点学科儿科学(2022-B17)

Characteristics of Unintentional Injuries in 15 773 Children

SHEN Yu, CHEN Jian, SHOU Tiejun, YU Beirong*()   

  1. Department of Pediatrics, Ningbo Women and Children's Hospital, Ningbo 315000, China
  • Received:2022-09-06 Revised:2023-03-27 Published:2023-09-15 Online:2023-04-06
  • Contact: YU Beirong

摘要: 背景 儿童非故意伤害是威胁儿童健康的主要原因,但多数是可预防的,各地的发生率和分布特征不同,根据当地特征制订相适应的预防措施是必要的。 目的 分析宁波市单中心儿童非故意伤害的临床特征,为制订相适应的预防与治疗措施提供依据。 方法 回顾性收集2020年8月—2021年7月宁波市妇女儿童医院急诊科就诊的0~17岁非故意伤害患儿的临床资料(年龄、性别、户籍、来院方式及院前应急救护情况、就诊时间、来院时长、受伤地点、发生原因、受伤部位、治疗结局、住院时间、住院费用),参考国际疾病分类法(ICD-10)对非故意伤害进行分类,并根据患儿的年龄将其分为婴儿期(n=1 225)、幼儿期(n=5 116)、学龄前期(n=4 447)、学龄期(n=3 219)和青春期(n=1 766),比较患儿不同临床资料在非故意伤害类型上的差异。 结果 共收集15 773例患儿临床资料,平均年龄为(5.3±3.6)岁,男女比为1.56∶1。幼儿期伤害以跌倒/坠落伤、烧烫伤、腔道异物、中毒、钝器伤、电击伤为主,学龄前期以道路交通伤害为主,学龄期以锐器伤为主;患儿以农村户籍为主(9 329/15 773,59.15%),跌倒/坠落伤、道路交通伤害、烧烫伤、腔道异物、锐器伤、电击伤、溺水患儿以农村户籍为主;跌倒/坠落伤、道路交通伤害、溺水患儿以自驾来院为主;跌倒/坠落伤、道路交通伤害、烧烫伤、中毒、锐器伤、电击伤、溺水患儿以无院前应急救护为主。患儿非故意伤害多发生于夏季(4 301/15 773,27.27%),道路交通伤害、烧烫伤多发生于夏季,钝器伤、电击伤多发生于秋季,咬伤多发生于春、秋季,7月和2月分别为患儿非故意伤害高发与低发月份,12:00和20:00为1日的就诊高峰期;道路交通伤害的来院时长低于其他类型的非故意伤害(P<0.05);非故意伤害主要发生在家庭(14 396/15 773,91.27%);儿童非故意伤害发生原因前三位分别是跌倒坠落伤(12 375/15 773,78.46%),道路交通伤害(835/15 773,5.29%)和烧烫伤(583/15 773,3.70%);非故意伤害发生部位多为头部(5 015/15 773,31.79%),婴儿期、学龄前期、学龄期患儿以头部伤害为主,幼儿期、青春期患儿以双上肢为主;溺水患儿的住院率、住院时间和住院费用高于其他类型的非故意伤害(P<0.05)。 结论 宁波市儿童非故意伤害多发于幼儿期,农村男童为主,主要为跌倒坠落伤和道路交通伤害,夏季高发,受伤以头部为主,儿童的不同特征会影响非故意伤害类型的发生,不同非故意伤害类型也会影响患儿的来院方式、来院时长、院前应急救护情况和住院结局。因此,应根据儿童特征针对性地开展宣教工作来减少儿童非故意伤害的发生,也要根据患儿非故意伤害类型制订合理的临床治疗策略。

关键词: 儿童, 非故意伤害, 特征分析, 预防, 回顾性研究

Abstract:

Background

Unintentional injuries are major threats to children's health, but most of them are preventable. Since the incidence and characteristics of distribution of unintentional injuries vary across regions, it is necessary to formulate preventive measures according to local characteristics.

Objective

To investigate the clinical characteristics of unintentional injuries in children in Ningbo, providing a theoretical basis for the development of relevant preventive and treatment measures.

Methods

This study retrospectively recruited 0-17-year-old children with unintentional injuries (including babies, toddlers, preschoolers, gradeschoolers and teens grouped by age) from Department of Emergency, Ningbo Women and Children's Hospital from August 2020 to July 2021. Clinical data were collected, including age, gender, registered residence, the way of getting to the hospital and pre-hospital emergency care, visit time, injury-to-admission time, places of occurrence of injury, cause of injury, site of injury, outcome of treatment, hospitalization time and hospitalization expenses. ICD-10 was used to classify the unintentional injuries, the children were divided into infancy (n=1 225), early childhood (n=5 116), preschool (n=4 447), school age (n=3 219) and adolescence (n=1 766) according to their age, and compared the types of unintentional injuries across the children by clinical data.

Results

Altogether, 15 773 cases〔including 9 608 males (60.91%) 〕were included, with a mean age of (5.3±3.6) years and a male to female ratio of 1.56∶1. Children with fall/fall injuries, burns and scald, cavity foreign body, poisoning, blunt instrument injury and electric shock injuries are mainly early childhood, road traffic injuries are mainly preschool age, and sharp instrument injuries are mainly school age. Most of the children were from rural areas〔59.15% (9 329/15 773) 〕. Children with rural household registration were mainly affected by falls/fall injuries, road traffic accidents, burns, foreign body aspiration, sharp instrument injuries, electric shocks and drowning. Children who suffered from falls, road traffic accidents and drowning mainly arrived at the hospital by self-driving. Children with fall/fall injuries, road traffic injuries, burns, poisoning, sharp device injuries, electric shock injuries and drowning are mainly treated without pre-hospital emergency rescue. Unintentional injuries occurred more frequently in summer〔27.27% (4 301/15 773) 〕. Road traffic injuries and burns are mainly in summer, blunt instrument injuries and electric injuries are mainly in autumn, and bites are mainly in spring and autumn. Unintentional injuries peaked in July and bottomed in February. Visits due to unintentional injuries peaked at 12:00 at noon and 20:00 in the evening. The injury-to-admission time in children with traffic injuries was shorter than that of those with the other injuries (P<0.05). The majority of injuries〔91.27% (14 396/15 773) 〕occurred at home. The top three causes of unintentional injuries were falls〔78.46% (12 375/15 773) 〕, traffics accidents〔5.29% (12 375/15 773) 〕, and burns〔3.70% (583/15 773) 〕. Most unintentional injuries occurred in the head 〔31.79% (5 015/15 773) 〕. Infant, preschool and school-age children mainly have head injuries, and preschool and adolescent children mainly have both upper limbs. Children with drowning had higher hospitalization rate, longer hospitalization time and higher hospitalization expenses than those with other types of unintentional injuries (P<0.05) .

Conclusion

Among Ningbo's children, unintentional injuries, mainly including falls/fall injuries and traffic injuries, highly occur in toddler age, with rural boys as the major suffering group, summer as the high-incidence season, and head as the major site. Different characteristics of children are associated with the type of unintentional injuries. And the type of unintentional injuries is associated with the way of getting to the hospital, injury-to-admission time, the use of pre-hospital emergency care and outcome of hospitalization. Thus, it is important to strengthen the preventive propaganda of unintentional injuries according to children's features to reduce the incidence of such injuries, and to develop rational clinical treatment strategies according to the types of unintentional injuries in children.

Key words: Child, Unintentional injury, Characteristic analysis, Prevention, Retrospective studies