Analysis of 551 Head Injured Children

兒童頭部外傷 551例之分析

陳嘉玲(Chai-Ling Chen) ； 黃美涓(May-Ken Wong) ； 張允藍(Yun-Lan Chang)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 131-137

摘要

為瞭解臺灣地區兒童頭部外傷的情況，以期找出有效之預防措施，本研究取自民國74年元月至民國78年12月共5年間，因頭部外傷至本院住院之兒童共551位。經由病歷查閱及問卷調查方式，加以統計分析。
個案以男性居多（男：女＝2.3：1）。年齡分佈以小於1歲，4-5歲及14-15歲兩組佔最多數。受傷地點以戶外最多，其中以馬路上受傷高居首位。戶內受傷者則以臥室最多。受傷原因以車禍佔最多數(64.97%)，其中以被汽車及機車撞倒高達58.66%。跌倒者次之，佔30.49%，其中以高處跌下為主。受傷發生率最高的季節是夏天，以5、6、7、8月最多。受傷時間則大多發生在下午3時至5時。以受傷程度而言，大部份兒童屬於輕度頭部外傷（77.86%），但嚴重頭部外傷者仍有122位（22.14%）。有25．23%兒童併有頭骨骨折，其中以線性骨折最多。併發其他部位骨折則以鎖骨及長骨最常見。電腦斷層攝影顯示常見受傷部位依次為額葉，顳葉及頂葉。其中有108位兒童需要接受腦部手術治療(19.60%)，其中有50位因死亡或病危自動出院，佔9.07%。
問卷調查目前僅收回131份回函。其中有121位得到相當良好的恢復，佔92.37%。

並列摘要

To investigate the nature of exposure factors, and effectiveness of countermeasures in head injuries in Taiwanese children with head injuries consecutively admitted to Chang Gung Memorial Hospital from Jan. 1985 to Dec. 1989. We analyzed the data by chart review. The analysis confirmed a boy to girl ratio of about 2.3 to 1. The largest number of head injuries was in children under 1 year, 4 to 5 years and more than 15 years of age. The most common place for head injuries to occur was outdoors, with the road contributing the most, while the bedroom was the most common site for indoor injuries to occur. The most common cause of pedicatric head injury was traffic accident (65%), of which most were hit by automobiles and motorcycles (59%). The next most common was falls (30%).Injuries were most common in summer (from May to August ) and clustered at 3:00-5:00 pm. Most children suffered from mild head injury (77.86%), but there were still 122 children with severe head injury (22.14%). Of the 25.23% of children with skull fracture, most had linear type. Fractures of clavicle and long bone were the most common concomitant skeletal fractures. The frontal, temporal and parietal accounted for the most focal sites of injury on computer tomogram in that order. Brain surgery was necessary in 19.60% of children. Fifty children (9.07%) were either discharged in a critical condition or died in hospital.

並列關鍵字

Head injury ； brain injury ； child ； epidemiology ； trauma