目的: 分析南京地区新型冠状病毒肺炎(COVID-19)疫情前、中、后3个阶段儿童骨折部位的分布差异,为后COVID-19时代儿童骨折防控提供依据。方法: 采用横断面研究设计,纳入2018—2023年南京医科大学附属儿童医院确诊骨折并住院的15 589例患儿,按时间段分为COVID-19前组(2018—2019年,n=5 077)、期间组(2020—2021年,n=5 028)和后组(2022—2023年,n=5 484)。应用单因素方差分析和卡方检验比较各组骨折部位分布差异,通过年龄、季节分层分析进一步验证。结果: 患儿平均年龄从COVID-19前组的(69.75±44.92)个月增加至COVID-19后组的(80.52±44.55)个月(P<0.001),婴幼儿比例持续下降,由23%下降至COVID-19期间组的19%及COVID-19后组的13%,学龄儿童和青少年比例分别上升至44%和14%。颅面骨折比例从19%上升至21%(P=0.007),上肢骨折比例从61%下降至58%(P=0.047)。年龄分层分析显示,婴幼儿和学龄儿童是受影响较大群体。年龄分层和季节分层分析结果与整体分析一致。结论: COVID-19疫情后南京地区儿童骨折呈现颅面损伤比例上升、上肢骨折比例下降的特征,年龄分布仍以学龄儿童为主。提示需针对后COVID-19时代儿童活动特点优化骨折预防策略。 |
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