| 脊柱脊髓开放性损伤21例救治 |
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投稿时间：2006-03-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 李青 |
LI Qing |
贵阳医学院附属医院急诊外科,贵州贵阳550004 |
Department of Emergency Surgery,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China |
liq168@hotmail.com |
| 郑昆 |
ZHENG Kun |
贵阳医学院附属医院急诊外科,贵州贵阳550004 |
Department of Emergency Surgery,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China |
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| 期刊信息：《中国骨伤》2006年，第19卷，第11期，第677-678页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨脊柱脊髓开放性损伤的临床特点、治疗及预后情况。
方法:21例脊柱脊髓开放性损伤患者,男17例,女4例;年龄15~47岁,平均25岁。损伤部位胸脊髓15例,腰脊髓5例,颈脊髓1例。术前ASIA分级A级8例,B级5例,C级6例,D级2例。6例伤口内有异物存留。21例均行急诊手术清创,根据损伤具体情况,行椎管探查、血肿清除、异物取出术。
结果:术后死亡1例(占4.8%),椎管感染1例(占4.8%),发生脑脊液漏2例(占9.5%)。1例术后脊髓损伤程度加重,2例术后神经功能有不同程度的恢复。术后ASIA分级A级9例,B级4例,C级5例,D级2例,E级1例。
结论:脊柱脊髓开放性损伤需在充分地术前准备下急诊手术治疗,术前应了解是否有异物存留,手术探查可以减少感染、出血等并发症的发生。 |
| 【关键词】脊柱骨折 脊髓损伤 外科手术 |
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| Management of open injuries of the spine and spinal cord in 21 patients |
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ABSTRACT
Objective:To investigate the clinical characteristics,treatment and prognosis of open injuries of the spine and spinal cord.
Methods:Twenty-one patients with open injuries of the spine and spinal cord(17 male and 4 female;the average age of 25 years ranging from 15 to 47 years) were treated.The injuried position was on thoracic in 15 cases,lumbar in 5,cervical in 1.Preoperative ASIA grade was grade A in 8 cases,grade B in 5,grade C in 6,grade D in 2.There were foreign bodies in wound of 6 patients.Debridement was a routine to do for open injuries of the spine and spinal cord in acute stage.Operations such as scrutinization of the spinal canal,clean-up of the hematoma,extraction of foreign bodies were optional according to different conditions.
Results: Among 21 patients,one died,cerebrospinal fluid leakage occurred in 2,meningomyelitis and wound infection was observed in 1.Neurological deficit deteriorated in 1,neurological deficit were improved after the operations in 2.Postoperative ASIA grade was grade A in 9 cases,grade B in 4,grade C in 5,grade D in 2,grade E in 1.
Conclusion:It is necessary that emergency operations for the patients with open injuries of the spine and spinal cord after enough preparations.It needs to know whether there are foreign bodies in wound before the operations.Operations such as scrutinization of the spinal canal and extraction of foreign bodies made it possible to avoid such complications as bleeding and infection. |
| KEY WORDS Spinal fractures Spinal cord injuries Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李青,郑昆.脊柱脊髓开放性损伤21例救治[J].中国骨伤,2006,19(11):677~678 |
| 英文格式: | LI Qing,ZHENG Kun.Management of open injuries of the spine and spinal cord in 21 patients[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(11):677~678 |
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