不同年龄段胸部创伤致伤原因及特征分析  

Causes and characteristics of chest trauma in different age groups

作　　者：王秋兰 姚猛飞 陈检明 陈松林 易云峰 Wang Qiulan;Yao Mengfei;Chen Jianming;Chen Songlin;Yi Yunfeng(Department of Anesthesiology,909th Hospital of Joint Logistics Support Force(Affiliated Dongnan Hospital of Xianmen University Medical College),Zhangzhou,Fujian Province 363000,China;Department of Emergency,909th Hospital of Joint Logistics Support Force(Affiliated Dongnan Hospital of Xianmen University Medical College),Zhangzhou,Fujian Province 363000,China;Department of Cardiothoracic Surgery,909th Hospital of Joint Logistics Support Force(Affiliated Dongnan Hospital of Xianmen University Medical College),Zhangzhou,Fujian Province 363000,China)

机构地区：[1]联勤保障部队第九〇九医院(厦门大学医学院附属东南医院)麻醉科,福建漳州363000 [2]联勤保障部队第九〇九医院(厦门大学医学院附属东南医院)急诊科,福建漳州363000 [3]联勤保障部队第九〇九医院(厦门大学医学院附属东南医院)心胸外科,福建漳州363000

出　　处：《创伤外科杂志》2023年第12期929-933,共5页Journal of Traumatic Surgery

基　　金：全军后勤科研项目(CWH17J030、CNJ14C007)。

摘　　要：目的探讨不同年龄段胸部创伤致伤原因及特征,为胸部创伤的救治提供依据。方法采用回顾性队列研究分析2019年3月—2021年3月联勤保障部队第九〇九医院收治的486例胸部创伤患者的临床资料,其中男性313例,女性173例;年龄12~80岁,平均43.0岁。根据患者年龄段分为未成年组(<18岁)46例、青年组(18~35岁)171例、中年组(36~60岁)214例及老年组(>60岁)55例;致伤原因:道路交通伤398例,锐器伤12例,高处坠落伤15例,摔伤16例,打击伤19例,其他26例。分析比较四组不同年龄段胸部创伤患者致伤原因、损伤类型及损伤情况、病死率情况。结果存活患者均获得随访6个月。不同年龄段道路交通伤、摔伤、打击伤及其他致伤原因的构成比比较差异有统计学意义(P<0.05)。打击伤易发生在未成年组(26.1%);道路交通伤易发生在各个年龄段,其中青年组93.6%、中年组86.9%;摔伤易发生在老年组(20.0%);锐器伤和高处坠落伤在不同年龄段间发生率的比较差异无统计学意义(P>0.05)。损伤类型主要为钝性损伤(84.8%),损伤情况以肋骨骨折(77.8%)、肺挫伤(90.3%)、血气胸(72.8%)为主。胸骨骨折易发生于未成年组(32.6%),老年组主要为钝性损伤(90.9%),肋骨骨折占比为87.3%,其他部位合并损伤在各个年龄段之间(未成年组43.5%,青年组47.9%,中年组50.9%,老年组36.4%)比较,差异无统计学意义(P>0.05)。本组病例共死亡5例,病死率1.03%,各年龄段患者病死率比较差异无统计学意义(P>0.05)。结论道路交通伤是最常见的胸部创伤致伤原因。未成年组胸部创伤常因打击伤造成,易合并胸骨骨折。青年组和中年组主要为道路交通伤;摔伤在老年组常见,表现为钝性损伤,易发生肋骨骨折。Objective To investigate the causes and characteristics of chest trauma in different age groups.Methods A cohort study was conducted to analyze the clinical data of 486 patients with chest trauma in our hospital from Mar.2019 to Mar.2021,including 313 males and 173 females.The mean age was 43.0 years,range 12-80 years.According to the age,patients were divided into juvenile group(<18 years old,n=46),youth group(18-35 years old,n=171),middle-aged group(36-60 years old,n=214),and elderly group(>60 years old,n=55).There were 398 cases of road traffic injuries(RTIs),12 sharp instrument injuries,15 falls from heights,16 ground-level falls,19 hitting injuries,and 26 others.The injury causes,types,classification,and mortality rates were analyzed based on age grouping.Results All the survivors were followed up for 6 months.The injury causes showed significantly different proportions among different age groups(P<0.05),with more hitting injuries in the juvenile group(26.1%),a high proportion of RTIs in all age groups(93.6%for the youth group and 86.9%for the middle-aged group),more ground-level falls among the elderly(20%),and nonsignificant proportions of sharp instrument injuries and falls from height among the four age groups(both P>0.05).The main injury type was blunt chest trauma(84.8%),with lung contusion accounting for 90.3%,followed by rib fractures(77.8%)and hemopneumothorax(72.8%).Sternal fractures are more likely to occur in the juvenile group(32.6%).For the elderly group,closed injuries are dominant(90.9%),with rib fractures accounting for 87.3%.The incidence of combined injuries in other parts was 42.5%in the juvenile group,47.9%in the youth group,50.9%in the middle-aged group,and 36.4%in the elderly group,revealing no significant difference(P>0.05).For this case series,5 patients died(1.03%)and the mortality rate was nonsignificant among four groups(P>0.05).Conclusion Road traffic accidents are the main cause of chest trauma.For juveniles,chest trauma is often caused by hitting and is prone to be combined wit

关 键 词：胸部创伤 致伤原因 危险因素 病死率 

分 类 号：R655[医药卫生—外科学]