小兒頭部外傷之臨床觀察

Clinical Observations of Head Injuries in Infants and Children

江季勛(Chi-Hsiun Chiang)

《Acta Paediatrica Sinica》 9卷4期 (1968/12) Pp. 191-202

摘要

著者就高雄醫學院近11年來小兒頭部外傷患者217例做臨床觀察及腦波檢討，同時與上述期間內就醫之成人頭部外傷患者466例做部分比較，得如下結果：
1．男女患兒之性別比較為2.3:1，成人男女之比為4.2:1。
2．每年平均約有19.7例患者，而以5～9歲幼兒佔多數(41%)。
3．小兒頭部外傷的原因以交通事故佔多數(44.7%)，其次為意外跌傷(37.3%)。成人頭部外傷的原因亦以交通事故佔首位(67.2%)。
4．小兒頭部外傷引起的顱骨骨折以凹陷骨折最多(58.6%)，而顱底骨折最少(10.4%)。
5．小兒頭部外傷死亡率為5.1%，低於成人之10.1%，死亡原因以交通事故最多(66.6%)，與成人者同(68.1%)。
6．有後遺症者佔58.5%，共中以記憶力減退者最多(63.2%)，有痙攣者最少(15.8%)，而後遺症的發生與外傷後意識障碍的長短無關。
7．檢查腦波結果有異常腦波者佔41.9%，而以全般性或局部徐波化現象佔大多數(74.2%)。異常腦波的發生與外傷的輕重度有關，但是與意識障碍的長短無關。

並列摘要

Two hundred and seventeen cases of head injuries under the age of 15 years were studied at the Kaohsiung Medical College Hospital during the past 11 years from 1957 to the end of 1967. Clinical findings and EEGs of these cases were further compared with 477 adult cases observed in the same period. The results were as follows:
1. The ratio of males to females in pediatric cases was 2.3:1, while that in adult cases was 4.2:1.
2. The average number of annual pediatric cases was 19.7. The majority of the cases were at The ages of between 5 and 9 years.
3. Traffic accident was the major cause of head injuries both in pediatric cases (44.7%) and in adults (67.2%), and fall was the next.
4. Depression fracture was the most common type of skull fractures (58.6%), and basal fracture (10.4%) was the least
5. The mortality rate of head injuries in infants and children (5.1%) was lower than that in adults (10.1%). The main cause of death was traffic accident in pediatric cases (66.6%) and also in adult cases (68.1%).
6. The incidence of post-traumatic sequelae was 58.8%. Memory disturbance was the most common one (63.2%) and epilepsy (15.8%) was the least. No significant correlation was noted between the duration of consciousness disturbance and the severity of sequelae.
7. Abnormal EEG was found in 41.9%. The most common abnormality was generalized or localized slowing. There was a significant positive correlation between the degree of severity, of injuries and the incidence of abnormal EEG. The duration of unconsciousness did not show a significant correlation with EEG abnormality.