Clinical Feature and Treatment of Spinal Fractures with Multiple Injury in “5·12” Wenchuan Earthquake_West China Medical Journal

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Department of orthopaedics, West China Hospital, Sichuang University, Chengdu 610041, China;

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Keywords：

地震; 脊柱骨折; 多發傷; 臨床特點; 治療

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目的:總結汶川大地震期間合并有多發傷的脊柱骨折的臨床特點和治療經驗。方法:回顧分析汶川大地震期間四川大學華西醫院收治的281例脊柱骨折,其中223例合并有多發傷,分析其臨床特點和治療方式。結果:223例合并多發傷的脊柱骨折中單純椎體骨折138例,單純附件損傷37例,椎體+附件骨折48例;平均年齡43.45±14.05歲;椎體分布以下胸段和腰段為主,胸腰段占60%左右;致傷原因中砸傷占82.1%;脊柱手術治療35例,占需手術治療的27.8%;合并傷共267例次;嚴重并發癥127例次;合并脊髓或馬尾神經損傷101例,占45.3%,有15例在搬運中發生脊髓損傷。結論:汶川大地震發生在山區,地震烈度高,傷員多為復合傷,存在嚴重的并發癥,受累椎體多,治療的重點首先放在處理開放傷、感染、并發癥上,影響了脊柱骨折的治療;早期救援時正確施救才能有效防范繼發性脊髓損傷。

Citation： MA Litai,LIU Hao,LIU Jin,et al.. Clinical Feature and Treatment of Spinal Fractures with Multiple Injury in “5·12” Wenchuan Earthquake. West China Medical Journal, 2009, 24(9): 2271-2273. doi: Copy

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1. .
2. 黃潤秋．“5．12”汶川大地震地質災害的基本特征及其對災后重建影響的建議[J]．中國地質教育,2008,17(2):21-24.
3. 胥少汀．脊髓損傷治療的主要環節[J]．中國脊柱外科雜志,2004,2(1):56 -60．.
4. RATHORE MF,RASHID P,BUTT AW,et al．Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake[J]．Spinal Cord,2007,45(10):658 -663．.
5. PRIEBE MM．Spinal cord injuries as a result of earthquakes:lessons from Iran and Pakistan[J]．J Spinal Cord Med,2007,30(4):367-368．.
6. KRAEMER WJ, SCHEMITSCH EH, LEVER J, 〖WTBX〗et al.〖WTBZ〗 Functional outcome of thoracolumbar burst fractures without neurological deficit[J]. J Orthop Trauma,1996,10(8):541-544.
7. ESSES SI, BOTSFORD DJ, KOSTUIK JP. Evaluation of surgical treatment for burst fractures[J]. Spine,1990,15(7):667-673.
8. DENIS F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries[J]. Spine,1983,8(8):817-831.
9. 王正國．地震災害的特點及其所致創傷的救治[J].中華創傷雜志,2008, 24 (6): 401-404.
10. BRACKEN MB, SHEPARD MJ, HOLFORD TR, et al. Administration of methylprednisolone for 24 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the third national acute spinal cord injury randomized controlled trial[J].JAMA,1997,277(20):1597-1604.
11. HEBERT JS, BURNHARM RS. The effect of ploytrauma in persons with traumatic spine injury. A prospective database of spine fractures[J].spine,2000,25(1): 55-60.

West China Medical Journal

Clinical Feature and Treatment of Spinal Fractures with Multiple Injury in “5·12” Wenchuan Earthquake

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