CAJ | 학술논문

目的探讨年龄与地面性质对高处坠落伤致伤规律及其严重度的影响,以期提高高处坠落伤的诊断与救治水平. 方法回顾性分析1996年1月至2006年12月收治的1 230例高处坠落伤患者资料,男925例,女305例;年龄为1 ～ 86岁,平均38.5岁.应用损伤严重度改良评分(RISS)评估损伤程度,分析不同年龄段(＜ 15岁、15～50岁、＞50岁)与地面性质(泥沙地面和水泥、石质地面)对高处坠落伤致伤规律及其严重度的影响. 结果＜15岁年龄段患者287例,颅脑及颌面伤占81.18％;15 ～50岁年龄段患者722例,颅脑及颌面伤占50.13％,脊柱伤占20.22％,胸部损伤占13.57％,下肢伤占38.23％,上肢伤占23.27％;＞50岁年龄段患者221例,颅脑及颌面伤占43.44％,脊柱伤占22.17％,胸部损伤占26.70％,下肢伤占33.48％,上肢伤占16.74％.3个年龄段患者损伤部位构成比和RISS分值构成比较差异均有统计学意义(P＜0.05).泥沙地面多发伤/多处伤患者构成比[23.91％ (22/92)]和RISS≥16分患者构成比[28.26％ (26/92)]均显著低于水泥、石质地面[46.15％(36/78)、52.56％ (41/78)],差异均有统计学意义(P＜0.05). 结论＜15岁年龄段患者多见颅脑及颌面部伤,以中度伤最多见;≥15岁年龄段患者多见脊柱、胸部、下肢及连锁性损伤,以中度伤及严重伤为主;坠落于水泥等坚硬地面者损伤严重度显著高于坠落于松软地面者.
목적 탐토년령여지면성질대고처추락상치상규률급기엄중도적영향,이기제고고처추락상적진단여구치수평. 방법 회고성분석1996년1월지2006년12월수치적1 230례고처추락상환자자료,남925례,녀305례;년령위1 ～ 86세,평균38.5세.응용손상엄중도개량평분(RISS)평고손상정도,분석불동년령단(＜ 15세、15～50세、＞50세)여지면성질(니사지면화수니、석질지면)대고처추락상치상규률급기엄중도적영향. 결과 ＜15세년령단환자287례,로뇌급합면상점81.18％;15 ～50세년령단환자722례,로뇌급합면상점50.13％,척주상점20.22％,흉부손상점13.57％,하지상점38.23％,상지상점23.27％;＞50세년령단환자221례,로뇌급합면상점43.44％,척주상점22.17％,흉부손상점26.70％,하지상점33.48％,상지상점16.74％.3개년령단환자손상부위구성비화RISS분치구성비교차이균유통계학의의(P＜0.05).니사지면다발상/다처상환자구성비[23.91％ (22/92)]화RISS≥16분환자구성비[28.26％ (26/92)]균현저저우수니、석질지면[46.15％(36/78)、52.56％ (41/78)],차이균유통계학의의(P＜0.05). 결론 ＜15세년령단환자다견로뇌급합면부상,이중도상최다견;≥15세년령단환자다견척주、흉부、하지급련쇄성손상,이중도상급엄중상위주;추락우수니등견경지면자손상엄중도현저고우추락우송연지면자.
Objective To investigate the impacts of age and ground surface on the injury caused by fall from heights.Methods A retrospective study was carried out to analyze the 1,230 patients who had been treated at our department for injury caused by falling from heights from January 1996 to December 2006.They were 925 males and 305 females,aged from 1 to 86 years (average,38.5 years).The injury was evaluated by revised injury severity score (RISS).The impacts of age (＜ 15 years,15 to 50 years and ＞ 50 years) and ground surface (soft ground and hard ground) on the injury were analyzed.Results Of the 287 patients of ＜ 15 years old,81.18％ had craniocerebral and maxillofacial injury.Of the 722 patients of 15 to 50 years old,50.13％ had craniocerebral and maxillofacial injury,20.22％ spinal injury,13.57％ chest injury,38.23％ lower limb injury,and 23.27％ upper limb injury.Of the 221 patients of ＞ 50 years,43.44％ had craniocerebral and maxillofacial injury,22.17％ spinal injury,26.70％ chest injury,33.48％ lower limb injury,and 16.74％ upper limb injury.There were significant differences among the 3 age groups regarding injury location and RISS score (P ＜ 0.05).The proportions of patients falling on the soft ground with multi-injury [23.91％ (22/92)] and with RISS≥ 16 [28.26％ (26/92)] were significantly lower than those falling on the hard ground [46.15％ (36/78) and 52.56％ (41/78)] (P ＜ 0.05).Conclusions Moderate craniocerebral and maxillofacial injury were common in the patients of ＜ 15 years old.Patients of ≥ 15 years old were commonly afflicted by moderate to severe spinal,chest and lower limb injuries.Falling on a hard ground caused a much more severe injury than falling on a soft ground.