儿童急诊面部外伤流行病学特征分析  

Epidemiological investigation of emergency children’s facial trauma

作　　者：孙海洋 谭晓燕[2] 姚平[2] 郭皓 施嫣彦[2] 李华[1] Sun Haiyang;Tan Xiaoyan;Yao Ping;Guo Hao;Shi Yanyan;Li Hua(Department of Plastic Surgery,Run Run Shaw Affiliated Hospital,Zhejiang University College of Medicine,Hangzhou 310016,China;Department of Plastic Surgery,Hangzhou Plastic Hospital,Hangzhou 310014,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院整形外科,杭州310016 [2]杭州整形医院整形外科,310014

出　　处：《中华整形外科杂志》2020年第8期860-865,共6页Chinese Journal of Plastic Surgery

摘　　要：目的:分析杭州整形医院急诊面部外伤患儿的流行病学特征。方法:调查分析杭州整形医院2017年1月1日至2018年12月31日急诊治疗的9 002例0~15岁面部外伤患儿的资料。统计性别、年龄、受伤时间、受伤后就诊时长、致伤原因、伤口部位、伤口类型、伤口长度、伤口深度、麻醉方式、术后抗瘢痕措施、术后瘢痕评估等情况,并对数据进行分析,采用 χ2检验分析计数资料。 结果:本组9 002例患儿中,男5 593例,女3 409例,男女比例约1.64∶1;年龄(4.6±2.9)岁,最小为出生后1个月。将患儿分为5个年龄段:≤1岁、>1岁且≤3岁、>3岁且≤6岁、>6岁且≤12岁、>12岁且≤15岁,其中>1岁且≤3岁的患儿最多,共4 505例(50.00%);从1岁至15岁患儿数量依次呈递减趋势,年龄段越大,男性患儿比例越大,差异具有统计学意义( χ2=23.12, P<0.001)。患儿受伤时间主要集中在9:00-12:00和16:00-21:00,最容易受伤的时间段是19:00-20:00。从全年来看,12月份患儿受伤人数最多,共1 002例(11.13%)。患儿大多于伤后6 h内就诊,共8 846例(98.27%)。主要致伤原因为撞伤(摔伤),共7 786例(86.49%)。最容易受伤的部位主要是额部,在≤3岁、>3岁且≤6岁、>6岁且≤15岁3组中,额部所占比例依次减小,受伤部位构成比之间相比较,差异具有统计学意义( χ2=401.22, P<0.001)。主要受伤类型为挫裂伤,共8 081例(89.77%)。受伤深度主要为中层(脂肪层、肌肉层),共5 262例(58.45%);其次为深层(软骨层、骨膜层),共3 601例(40.00%)。伤口总长度为(1.9±1.0) cm(0.2~15.0 cm)。麻醉方式主要是局部麻醉,部分采用静脉麻醉或全麻插管麻醉,共8 757例(97.28%)。术后随访7 465例,所有随访患儿应用整形美容技术一期或分期治疗,术后采用一种或联合多种抗瘢痕措施治疗。随访时间3个月至2年,术后感染8例,主要发生在动物抓咬伤、唇部贯通伤及被牙齿磕伤患儿,瘢痕增生28例,其余患儿均效�Objective To analyze the epidemiological characteristics of emergency children’s facial trauma in Hangzhou Plastic Surgery Hospital.Methods Medical records of emergency children’s facial trauma,aged 15 and under,were collected from January 1,2017 to December 31,2018.Data of gender and age,time of trauma,visiting time,causes of trauma,location,types,length and depth of wound,anesthesia method,treatment and evaluation of postoperative scars were analyzed and enumeration data were processed with chi-square test.Results 9002 cases(male 5593 cases,female 3409 cases)were in the group.The ratio of male to female was 1.64∶1.The age range was(4.6±2.9)years old,the youngest case was 1 month.They were divided into 5 age brackets:less than or equal to 1 year old,more than 1 year old and less than or equal to 3 years old,more than 3 years old and less than or equal to 6 years old,more than 6 years old and less than or equal to 12 years old,more than 12 years old and less than or equal to 15 years old.Children more than 1 year old and less than or equal to 3 years old ranked the largest number(4505 cases,50.0%)in the 5 age brackets.There was statistically significant difference in constituent ratios of gender of children among the 5 age brackets(χ2=23.12,P<0.001).Children’s facial trauma mainly occurred in 9:00-12:00 and 16:00-21:00,the most injury time was 19:00-20:00.Children’s facial trauma was more likely to happen in December(1002,11.13%).Contuse(falling)was the main cause of trauma(7786,86.49%).The vulnerable anatomic site was forehead.In the 3 age brackets(less than or equal to 3 year old,more than 3 year old and less than or equal to 6 years old,more than 6 years old and less than or equal to 15 years old),the proportion of forehead injury was decreased in turn and there was statistically significant difference in constituent ratios of trauma site(χ2=401.22,P<0.001).The main trauma type was contused laceration(8757,97.28%).The wound depth was mainly middle layer(fat layer,muscular layer,5262,58.45%)and the

关 键 词：儿童 急诊处理 面部损伤 瘢痕 流行病学 

分 类 号：R726[医药卫生—儿科] R181.3[医药卫生—临床医学]