陈秀芹 黄丽妹 喻彦 姚春霞

摘 要 目的：了解上海松江區小学生跌倒伤害流行病学特征和影响因素，为开展相应干预措施提供科学依据。方法：采用整群抽样方法，抽取松江区4所小学3 715名小学生为研究对象进行问卷调查，其中男生1 928人，女生1 787人，平均年龄10.3岁。由学生和家长共同完成问卷，分析小学生的跌倒伤害的现状和影响因素。结果：上海松江区小学生跌倒伤害发生率为10.9%，男生（OR=1.370，95%CI：1.108～1.694）、家庭收入低（OR=1.156，95%CI：1.016～1.316）、住宅楼梯有致跌危险因素（OR=1.344，95%CI：1.072～1.684）、家庭阳台或窗边有摆放桌椅（OR=1.341，95%CI：1.015～1.774）是学生跌倒伤害发生的危险因素，本市户籍（OR=0.743，95%CI：0.596～0.928）、从未让孩子独自在运动场所玩耍（OR=0.836，95%CI：0.715～0.978）、孩子活动环境无不平道路（OR=0.747，95%CI：0.632～0.883）、学生认为跌伤可以预防（OR=0.687，95%CI：0.521～0.905）是学生跌倒伤害发生的保护因素。结论：上海松江区小学生跌倒伤害问题较严重，应针对学生跌倒发生的危险因素采取有针对性的干预措施。

关键词 跌倒；伤害；小学生；影响因素

中图分类号：R179 文献标志码：A 文章编号：1006-1533（2020）14-0051-05

Analysis of the current situation and influencing factors of fall injuries in pupils in Songjiang District， Shanghai

CHEN Xiuqin1， HUANG Limei1， YU Yan2， YAO Chunxia3

（1. Injury Department of Songjiang District Center for Disease Control and Prevention， Shanghai 201620， China； 2. Injury Prevention Department of Shanghai Municipal Center for Disease Control and Prevention， Shanghai 200336， China； 3. School Health Department of Songjiang District Center for Disease Control and Prevention， Shanghai 201620， China）

ABSTRACT Objective： To understand the epidemiological characteristics and influencing factors of fall injuries in pupils in Songjiang District of Shanghai to provide scientific basis for carrying out corresponding intervention measures. Methods： Using cluster sampling method， 3 715 pupils in 4 primary schools in Songjiang District were selected as the research objects for questionnaire survey， among them， there are 1 928 boys and 1 787 girls， with an average age of 10.3 years. The pupils and their parents completed the questionnaire together and the current situation and influencing factors of fall injuries of the pupils were analyzed. Results： The incidence rate of pupil falling injury in primary schools of Songjiang District was 10.9%. The risk factors of pupil falling injury were male（OR=1.370，95% CI：1.108～1.694）， lower household income（OR=1.156，95% CI：1.016～1.316）， residential stairs with risk factors（OR=1.344， 95% CI： 1.072～1.684）， and balcony or windows of the home placed tables and chairs（OR=1.341， 95% CI： 1.015～1.774）； protective factors were registered permanent residence of the city（OR=0.743， 95% CI： 0.596～0.928）， never letting children play alone in sports place（OR=0.836， 95% CI： 0.715～0.978）， childrens activity environment with no uneven road（OR=0.747， 95% CI： 0.632～0.883）， and pupils thinking that falling injury could be prevented（OR=0.687， 95% CI： 0.521～0.905）. Conclusion： The problem of fall injury in pupils in Songjiang District of Shanghai is more serious， intervention and control of pupils falling injury should be done in relation to the influencing factors， and targeted intervention measures should be taken against the risk factors of pupils falling.

KEY WORDS fall； injury； pupil； influencing factor

跌倒作为全球第二位伤害死亡原因，每年致死64.6万人，仅次于道路交通伤害[1]。跌倒也是造成我国儿童伤害的主要原因[2-3]，在我国，每一例儿童跌倒死亡，往往伴随4例儿童永久残废，13例儿童需要住院治疗10 d以上，24例儿童需要住院治疗1～9 d，690例儿童需要寻求医疗诊治或休工/休学[1]。据全国门急诊伤害监测系统资料显示，跌倒已成为近十年来上海松江区5～14岁儿童发生伤害的首位原因[4-5]，给儿童身心带来严重损害，对社会和家庭造成了巨大经济负担。本研究旨在分析上海松江区小学生跌倒伤害发生的流行病学特征，探索相关影响因素，为开展和制定防控策略和措施提供依据。……