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; 多发伤; 临床特点; 治疗

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目的:总结汶川大地震期间合并有多发伤的脊柱骨折的临床特点和治疗经验。方法:回顾分析汶川大地震期间四川大学华西医院收治的281例脊柱骨折,其中223例合并有多发伤,分析其临床特点和治疗方式。结果:223例合并多发伤的脊柱骨折中单纯椎体骨折138例,单纯附件损伤37例,椎体+附件骨折48例;平均年龄43.45±14.05岁;椎体分布以下胸段和腰段为主,胸腰段占60%左右;致伤原因中砸伤占82.1%;脊柱手术治疗35例,占需手术治疗的27.8%;合并伤共267例次;严重并发症127例次;合并脊髓或马尾神经损伤101例,占45.3%,有15例在搬运中发生脊髓损伤。结论:汶川大地震发生在山区,地震烈度高,伤员多为复合伤,存在严重的并发症,受累椎体多,治疗的重点首先放在处理开放伤、感染、并发症上,影响了脊柱骨折的治疗;早期救援时正确施救才能有效防范继发性脊髓损伤。

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. 黄润秋．“5．12”汶川大地震地质灾害的基本特征及其对灾后重建影响的建议[J]．中国地质教育,2008,17(2):21-24.
3. 胥少汀．脊髓损伤治疗的主要环节[J]．中国脊柱外科杂志,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. 王正国．地震灾害的特点及其所致创伤的救治[J].中华创伤杂志,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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