台灣北部地區兒童事故傷害之探討
兒童事故傷害一直以來都是公共衛生上的一大問題，不論國內外都是造成兒童死亡的首
要原因。本研究將針對台灣北部地區 0-14 歲因事故傷害至急診就醫之兒童，探討其事 故傷害之性別、年齡、受傷時間分佈、發生的原因、傷害的型態及嚴重度，並針對較常 發生之兒童事故傷害，找出相關之危險因子。本研究對象來自民國 90 年 2 月 1 日至 91 年 1 月 31 日台灣北部地區五家醫院的創傷病患。共收集 1,430 名事故傷害之兒童。以 1 0-14 歲年齡層兒童居多（ 36.2 ％），男女比為 1.5 ；事故發生原因以交通事故（ 42.5
% ）最多，其次為跌落（ 36.9% ）；事故發生時間主要在 5-8 月，時段以上午十點至十 二點及下午四點至六點為多。受傷嚴重度〈 Injury Severity Score 〉中，輕度傷害者佔 6 0.8% ，中重度傷害佔 30.4% ；受傷部位以四肢傷害最多（ 73.2% ）；受傷診斷則以四 肢骨折最多（上肢 30.1% ，下肢 21.0% ）。造成嚴重傷害之交通事故的危險因子包括 母親年齡 50 歲以上（ 50-59 歲 OR=2.13 ， 95%CI 1.15-2.21 ； 60 歲以上 OR=3.23 ， 95
％ CI 2.21-3.34 ），母親教育程度（高中以下 OR=4.76 ， 95%CI 3.12-5.53 ），沒有照 顧者在場（ OR=2.32 ， 95%CI 1.23-4.48 ）、沒有防護設備（ OR=38.9 ， 95%CI 2.32-4 4.4 ）及相關之受傷部位（頭、胸及四肢）。而造成嚴重傷害之跌落的危險因子也是和 交通事故類似包括母親教育程度（高中以下 OR=4.62 ， 95%CI 3.32-5.43 ），沒有照顧 者在場（ OR=4.32 ， 95%CI 1.34-4.48 ）、沒有防護設備（ OR=34.1 ， 95%CI 33.3-143.
2 ）及頭部受傷。兒童事故傷害的發生，雖不能完全避免，但大部份都是可以事先預防 的，本研究發現造成兒童交通事故與跌落傷害與照顧者是否在場及發生危險時是否有防 護設備為主，今後應多從這兩方面著手。
A Study of Child Injuries in Northern Taiwan
Childhood injury has always being a major public health issue. It is the main cause of death up on children around the world. Our study will be focused on children at age group of 0-14 years old who had admit to an emergency department located in the northern region of Taiwan due t o injury. Topics on sex, age, distribution of time of injury, the cause of injury, the morphology and severity of injury will be discussed. Furthermore, emphasis will be placed upon frequently occurred injuries to find its related risk factors. Samples were obtained from five hospitals loc ated in northern region of Taiwan from February 1st, 2001- January 31st, 2002. A total of 1,43 0 cases were collected. Age level of 10-14 has the majority of patients (36.2%); male was 1.5 t imes higher in ratio; traffic accident was the main cause of childhood injury(42.5%) and was f ollowed by falls (36.9%); majority of injury occurs during the months from May till August es pecially during the time period from 10-12 A.M. and 4-6 P.M. According to the Injury Severit y Score, mild injury occupies 60.8%, moderate and severe injury occupies 30.4%; majority of injuries occurs to the four limbs (73.2%); limb fracture was mostly seen among injured patient s (upper limb 30.1%, lower limb 21.0%). The risk factors of severe injury caused by traffic acc idents include: mother with age 50 years old and above (50-59 yrs OR = 2.13, 95%CI ＝ 1.15- 2.21; 60 yrs and above OR = 3.23, 95%CI ＝
A Study of Child Injuries in Northern Taiwan
2.21-3.34); mother’s educational level (below high school OR = 4.76, 95%CI ＝ 3.12-5.53); w hether help or care was provided on site (OR = 2.32, 95%CI ＝ 1.23-4.48); whether a protecti ve equipment was worn (OR = 38.9 95%CI ＝ 2.23-44.4) and related area of injury. Similarly, the risk factors of severe injury caused by falls include: mother’s educational level (above uni versity OR = 4.62, 95%CI ＝ 3.32-5.43); whether help or care was provided on site (OR = 4.3 2, 95%CI ＝ 1.34-4.48); whether a protective equipment was worn (OR = 34.1, 95%CI ＝ 33.
3-143.2) and head injury. Occurrences of childhood injury can be much reduced if more attent ion is placed upon preventions. Our study has shown both intervention of medical support on s ite and protective equipment worn during the accident were the major factors that influence th e later outcome of the patient. Future study should be focused on these two factors in order to r educe the number of injuries.
