交通事故与高处坠落致骨伤特点分析  

Characteristic analysis of bone injuries following traffic accident and fall from high places

作　　者：谭宗奎[1] 陈庄洪[1] 蔡贤华[1] 黄继锋[1] 苏红军[1] 

机构地区：[1]广州军区武汉总医院骨科,湖北武汉430070

出　　处：《创伤外科杂志》2004年第2期97-99,共3页Journal of Traumatic Surgery

摘　　要：目的　探讨交通事故与高处坠落致骨伤的特点及其差异。方法　对 6 6 9例交通事故与 30 8例高处坠落致骨伤病例进行比较分析 ,全部病人用创伤改良评分法 (RISS)评估损伤程度 ,所得数据运用 χ2 检验进行统计学处理。结果　交通事故所致骨伤的损伤部位及伤情程度与车辆撞击方式、车辆类型、车速等因素有关 ;高处坠落伤的损伤部位和伤情程度取决于坠落高度、着地姿势、地面性质、年龄及体重等因素。本组交通事故以开放性损伤居多 ,锁骨、肋骨骨折所占比率较大 ,四肢骨折以左侧肢体更为常见。高处坠落以多发性损伤更为突出 ,常伴有其它部位的连锁性损伤 ,脊柱、肱骨、尺桡骨骨折所占比例较大 ,并易发生颅脑及胸腹腔内脏器损伤。RISS评估损伤程度 ,交通事故平均RISS 1 3.4 1 ,高处坠落平均RISS 1 7.5 0。高处坠落比交通事故损伤程度严重 ,伤后遗留功能障碍者较多。结论　致伤原因不一 ,其损伤类型、程度各异。交通事故与高处坠落导致的各类骨折及合并伤的发生情况、创伤严重度。Objective To investigate the characteristics and differences that bone injuries between traffic accident and fall from high places.?Methods The records of the patients admitted with bone injuries following traffic accidents(669 cases) and fall from high places(308 cases)were analysed.?The feature and severity of the injury were evaluated by means of revised injury severity score(RISS).?All data were tested with χ 2 test.?Results The patterns and severity of bone injuries in traffic accidents were decided by the way of vehicle impact,the type of vehicle,and the speed of the vehicle.?Bone injuries from fall from high places depend upon the fall height,the landing position,the ground circumstanes,the age and weight of the patient.?In traffic accident group,open injuries seem to be more frequent.?There is a high rate of fractures in collar bones and ribs.?Moreover,extremity bone fractures are frequently found on the left side limbs.?In fall from high place group,multiple injuries seem to be more frequent.?Fractures in spine,humerus,ulnas and radius are frequently found.?The patient is more apt to suffer injury in head,thoracic or abdominal viscera.?By RISS valuation of injury severity,average RISS 13.41 was found in traffic accident patients,but average RISS 17.50 was found in patients who fell from high places.?The severity of injuries was more serious in the latter than the former group.?Besides,the rate of severe injuries and dysfunction after trauma was higher in the latter group.?Conclusion This study demonstrates that there exists a change in the patterns and severity of the injury because the causes of injury are different.?There is a significant difference between traffic accident and fall from high places in incidence of fractures and complication of other injuries,injury severity,disabilities and death rate.

关 键 词：创伤 交通事故 坠落伤 骨折 创伤严重度评分 

分 类 号：R683[医药卫生—骨科学]