【摘要】 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。更多还原

【Abstract】 Objective:To summarize the clinical feature and treatment of spinal fractures with multiple injury in "5·12" Wenchuan Earthquake.Methods:281 cases with spinal fractures treated in West China Hospital during Wenchuan Earthquake were retrospectively analyzed.There were 223 cases with multiple injury.Results:In the 223 cases,138 were single vertebral body fracture,37 single accessory fracture,and 48 vertebral and accessory fractures.Average ages were 43.45±14.05 years old.Thoracolumbar fractures were 60 percent in all spinal fractures.The cause of fracture mostly were smash.There were 35 cases be operated which were 27.8 percent in all cases who need operation.There were 267 cases with multiple injury and 127 cases with serious complication.There were 101 cases with spinal cord injury or Cauda equina nerves injury,and 15 cases suffered spinal cord injury during transportation.Conclusion:There were many multiple injury and serious complication in Wenchuan Earthquake.The most important attention were to deal with wounds,infections and complications which delay to treatment of spinal fractures.The chief manner is correct first aid early which can be keep away secondary spinal cord injury.更多还原