台灣北部地區兒童事故傷害之探討
A Study of Child Injuries in Northern Taiwan
中文摘要
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 10-14 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 60.8%，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 2.32-44.4）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。
英文摘要
Childhood injury has always being a major public health issue. It is the main cause of death upon 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 to 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 located in northern region of Taiwan from February 1st, 2001- January 31st, 2002. A total of 1,430 cases were collected. Age level of 10-14 has the majority of patients (36.2%); male was 1.5 times higher in ratio; traffic accident was the main cause of childhood injury(42.5%) and was followed by falls (36.9%); majority of injury occurs during the months from
May till August especially during the time period from 10-12 A.M. and 4-6 P.M.
According to the Injury Severity 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 patients (upper limb 30.1%, lower limb 21.0%). The risk factors of severe injury caused by traffic accidents 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 ＝2.21-3.34); mother＇s educational level (below high school OR = 4.76, 95%CI＝3.12-5.53); whether help or care was provided on site (OR = 2.32, 95%CI＝1.23-4.48); whether a protective 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 university OR = 4.62, 95%CI＝3.32-5.43); whether help or care was provided on site (OR = 4.32, 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 attention is placed upon preventions. Our study has shown both intervention of medical support on site and protective equipment worn during the accident were the major factors that influence the later outcome of the patient. Future study should be focused on these two factors in order to reduce the number of injuries.
