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Journal Article

Citation

Shen Y, Chen J, Shou T, Yu B. Zhongguo quanke yixue 2023; ePub(ePub): ePub.

Vernacular Title

15 773 例儿童非故意伤害特征分析

Copyright

(Copyright © 2023, Zhongguo quan ke yi xue za zhi bian ji wei yuan hui)

DOI

10.12114/j.issn.1007-9572.2023.0024

PMID

unavailable

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. We described systematically the incidence and characteristics of distribution of unintentional injuries in Ningbo's children.

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. Chi-square test and Kruskal-Wallis H test were used to compare 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(5.30±3.64)years and a male to female ratio of 1.56∶1. The prevalence of unintentional injuries
in toddler age was the highest〔32.44%(5 116/15 773)〕. 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(4 301/15 773,27.27%). 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(14 396,91.27%)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

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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
尽相同,根据当地特征制定相适应的预防措施是必要的。因此本研究系统地描述了宁波地区儿童非故意伤害临床特征。
目的 分析宁波市单中心儿童非故意伤害的临床特征,为制定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、幼儿期、学龄
前期、学龄期和青春期,采用 χ2 检验、Kruskal-Wallis H 检验等统计方法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 例临床资料,平均年龄为(5.30±3.64)岁,其中男性患儿 9 608 例(60.91%),男女
比为 1.56 ∶ 1;幼儿期发生非故意伤害例数最高(5 116/15 773,32.44%),跌倒 / 坠落伤、烧烫伤、腔道异物、中毒、
钝器伤、电击伤患儿以幼儿期为主,道路交通伤害以学龄前期为主,锐器伤以学龄期为主;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、
烧烫伤以夏季为主,钝器伤、电击伤以秋季为主,咬伤以春、秋季为主,7 月和 2 月分别为患儿发生非故意伤害高发
与低发月份,12:00 和 20:00 为 1 天中的就诊高峰期;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 例(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定合理
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


Language: zh

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