Salim Ali, Ottochian Marcus, Gertz Ryan J, Brown Carlos, Inaba Kenji, Teixeira Pedro G R, Rhee Peter, Demetriades Demetrios
Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine.
Am Surg. 2007 Oct;73(10):1035-8.
The evaluation of the abdomen in patients with spinal cord injury (SCI) is challenging for obvious reasons. There are very little data on the incidence and complications of patients who sustain SCI with concomitant intraabdominal injury (IAI). To determine the incidence and outcomes of IAI in blunt trauma patients with SCI, a trauma registry and record review was performed between January 1998 and December 2005. Baseline demographic data, Injury Severity Score, and associated IAI were collected. Two groups were established and outcomes were analyzed based on the presence or absence of IAI. Intraabdominal and hollow viscus injures were found in 15 per cent and 6 per cent, respectively, of 292 patients with blunt SCI. The presence of intraabdominal injury varied according to the level of the SCI: 10 per cent of cervical, 23 per cent of thoracic, and 18 per cent of lumbar SCI. The overall mortality was 16 per cent. The presence of intraabdominal injury was associated with longer intensive care unit length of stay (13 versus 6 days, P < 0.01), hospital length of stay (23 versus 18 days, P < 0.05), higher complication rate (46% versus 33%, P = 0.09), and higher mortality (44% versus 11%, P < 0.01) when compared with patients with SCI without IAI. Intraabdominal injuries are common in blunt SCI. Liberal evaluation with computed tomography is necessary to identify injuries early.
由于显而易见的原因,对脊髓损伤(SCI)患者的腹部进行评估具有挑战性。关于脊髓损伤合并腹内损伤(IAI)患者的发病率和并发症的数据非常少。为了确定钝性创伤性脊髓损伤患者腹内损伤的发病率和预后,于1998年1月至2005年12月进行了一项创伤登记和记录回顾。收集了基线人口统计学数据、损伤严重程度评分和相关的腹内损伤情况。根据是否存在腹内损伤建立了两组,并对预后进行了分析。在292例钝性脊髓损伤患者中,分别有15%和6%发现了腹内和中空脏器损伤。腹内损伤的存在因脊髓损伤的水平而异:颈椎损伤患者中为10%,胸椎损伤患者中为23%,腰椎损伤患者中为18%。总体死亡率为16%。与无腹内损伤的脊髓损伤患者相比,腹内损伤的存在与重症监护病房住院时间延长(13天对6天,P<0.01)、住院时间延长(23天对18天,P<0.05)、更高的并发症发生率(46%对33%,P=0.09)和更高的死亡率(44%对11%,P<0.01)相关。腹内损伤在钝性脊髓损伤中很常见。需要进行计算机断层扫描的全面评估以早期发现损伤。