Objective: To investigate the causes and clinical features of children with traumatic brain injury (TBI) who need hospitalization or emergency observation.
Methods: A retrospective analysis was performed for the clinical data of 126 children with TBI who were admitted to the emergency department from January 1, 2014 to August 31, 2016, including causes of injury and clinical features.
Results: Of the 126 children, there were 95 boys and 31 girls, with a mean age of 2.8 years (range 0.8-5.5 years). The children aged <1 year accounted for 38.1% (48/126), and 26 children died. The two most common types of TBI were epidural hematoma (54.0%) and subarachnoid hemorrhage (50.8%). Of the 126 children, 83 (65.9%) had a Glasgow Coma Scale score of ≤8 within 24 hours after admission. There were different causes of TBI and places where TBI occurred in different age groups. The two leading causes of TBI were falls (51.6%) and road traffic injuries (42.9%). Compared with those in the other age groups, the children in the age <1 year group were most likely to experience injury due to falls (46%; P=0.023). Thirty-five percent of all TBI due to road traffic injuries occurred in the children aged 3-6 years (P<0.001). Most TBI cases occurred at home (47.6%) or on roads/streets (45.2%). Among those who experienced TBI at home, the children aged <1 year accounted for the highest proportion of 48% (P=0.002), and 53% of the patients aged 3-6 years experienced TBI on roads/streets. The most common cause of death in children with TBI was road traffic injury, which accounted for 69%. Among those who died, the children aged <1 year accounted for the highest proportion (62%).
Conclusions: There are different causes of TBI and places where TBI occurs in different age groups. Among children with TBI, the children aged <1 year account for the highest proportion and have the highest number of deaths, with falls at home as the most common cause of TBI. Children aged 3-6 years tend to suffer TBI due to road traffic injury. Road traffic injury is the leading cause of death.
目的: 分析需住院或留院观察的颅脑外伤（TBI）患儿的致伤因素及临床特点。
方法: 收集2014年1月1日至2016年8月31日于急诊科就诊且需留院治疗的126例TBI患儿的临床资料，对其致伤因素及部分临床特点做回顾性分析。
结果: 126例TBI患儿中，男95例，女31例，年龄2.8（0.8，5.5）岁，以 < 1岁者最多（48/126，38.1%），死亡26例。TBI类型前2位是硬膜外血肿（54.0%）、蛛网膜下腔出血（50.8%），入院24 h内有83例（65.9%）患儿Glasgow昏迷量表评分≤ 8分。不同年龄组TBI致伤因素、发生场所各不相同。TBI最常见的前2位致伤因素为坠落/摔伤（51.6%）和道路交通伤害（42.9%）。与其他年龄段相比， < 1岁患儿最易发生坠落/摔伤（46%，P = 0.023）。道路交通伤害所致TBI高发年龄段为3~6岁（35%，P < 0.001）。伤害发生场所集中于家中（47.6%）和公路/街道（45.2%）；所有家中致伤患儿中， < 1岁组所占比例最高（48%，P = 0.002），3~6岁患儿主要受伤地点为公路/街道（53%）。造成TBI患儿死亡的首位致伤因素是道路交通伤害（69%）；死亡病例中，以 < 1岁患儿最多（62%）。
结论: 不同年龄组TBI患儿的致伤因素和发生场所不尽相同。1岁以下儿童发生TBI比例高、死亡人数最多，多为家中发生坠落/摔伤所致。3~6岁儿童易因道路交通伤害发生TBI。道路交通伤害最易导致死亡。