臺灣博碩士論文加值系統

機車在台灣地區已成為最普遍的交通工具,近年來機車事故不斷增加,而頭部外傷又與機車
事故有強烈相關.台灣地區於86年6月1日起實施機車騎士及乘客強制戴安全帽法案,違者罰
鍰新台幣五百元.本研究以安全帽立法前後之機車事故頭部外傷發生情形''嚴重度''預後結
果,來分析安全帽法案對機車事故頭部外傷防治之影響.研究收集85年6月1日至87年1月31
日止之台灣地區七家醫院機車事故頭部外傷案例''健保局機車事故外傷醫療費用資料''交通
大隊收集之機車事故案件資料,以時間配對比較立法前後機車事故頭部外傷減少情形,以評
估機車安全帽對頭部外傷的功效.研究期間共收集頭部外傷9860例,年齡層以20-29歲為主.
而比較立法前(85年6月1日至86年1月31日)與立法後(86年6月1日至87年1月31日)之機車事
故頭頭部外傷情形,發現立法後機車車禍頭部外傷事故比例法前減少17.4%,住院天數減少,
嚴重度也減輕,預後情形變良好.傷後發生意識障礙情形減少15%,發生顱骨骨折及顱內出血
減少10-20%,並皆達到統計顯著水準(p<0.0001). 調整性別''年齡後,未戴安全帽者機車事
故頭部外傷死亡機率是有戴者的17.08倍,發生嚴重傷害情形是有戴者的7.08倍,並達統計
顯著差異.詳細分析安全帽形式,發現全罩式安全帽較半罩式安全帽保護效果佳.分析中央
健康保險局機動車事故住院病例資料,發現立法後健保局因機動車交通意外住院醫療費用
支出平均每月減少一億一千萬元.分析交通部資料,發現實施騎乘機車需戴安全帽法案後,
車禍頭部外傷情形較86年5月減少28%,需要開顱手術者減少31%,而在86年執行7個月安全帽
法案後,騎乘機車未戴安全帽法案死亡人數較85年減少423人,衛生署資料也顯示86年交通
事故死亡人數較85年少561人.由本研究資料可知機車安全帽確實有保護頭部的效果,不但
大幅減少頭部外傷死亡率及嚴重度,並節省醫療費用支出.但目前安全帽使用率又有逐漸降
低的趨勢,尤以鄉村地區使用率降至四成以下,因此需持續強制執行騎乘機車戴安全帽法案
,以挽救更多的生命.

In Taiwan, motorcycles are the most common means of transportation and account
for 65% of all motor vehicles. Most serious or fatal motorcycle-related injur
ies involve the head, so it is with great excitement that we inform youthat a
motorcycle helmet use law was passed and enacted in the whole nation on June 1
, 1997. In order to evaluate the effect of the helmet law, we comparedthe hea
d injury situtations in the same months before and after implementation of the
helmet law. From June 1, 1996 to January 31, 1998 we collected 9,860 motorcy
cle-related head injury cases from 7 major hospitals in Taiwan. Dataanalysis
showed that after implementation of the law (June 1, 1996 to January31, 1997),
the incidence of motorcycle-related head injury decreased by 17.4%when compar
ed to the incidence before the law(June 1, 1997 to January 31,1998).Decreases
in length of hospital stay and severity and better outcome were alsoseen. Aft
er the helmet law, the incidence of conscious disturbance decreases by 15%, th
e incidence of skull fracture and intracranial hematoma decreased by10-20% (p<
0.0001). After adjusting for sex and age, we found out that unhelmeted motorc
yclists were 17.08 times more likely to die from motorcycle-related head injur
ied and 7.08 times more likely to suffer from severe injuriesthan helmeted mot
orcyclists. In addition, full helmets were found to be saferthan half-shell h
elmets. Analysis of data provided by the National Healtht Insurance Bureau sh
owed that after implementation of the helmet law, the costsof motorcycle-relat
ed injury hospitalizations decreased by an average of US$ 3.93 million per mon
th, and the number of fatalities in 1997 decreased by561 when compare to 1996.
From these figures, it is evident that the helmet law effectively decreased
the incidence and severity of motorcycle-related head injury and reduced relat
ed medical costs.