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创伤性脊柱骨折的表现与预后

Presentation and outcome of traumatic spinal fractures.

作者信息

El-Faramawy Ahmed, El-Menyar Ayman, Zarour Ahmad, Maull Kimball, Riebe Jane, Kumar Krishna, Mathew John, Parchani Ashok, Al-Thani Hassan, Latifi Rifat

机构信息

Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.

出版信息

J Emerg Trauma Shock. 2012 Oct;5(4):316-20. doi: 10.4103/0974-2700.102381.

Abstract

BACKGROUND

Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability.

AIM

To define the incidence, causes, and outcome of spinal fractures.

MATERIALS AND METHODS

Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009.

RESULTS

Among 3712 patients who were admitted to the section of trauma surgery, 442 (12%) injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5%) and falls from height (19.3%) were the leading causes of cervical injury (P = 0.001). The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04). Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001). Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001). The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%.

CONCLUSIONS

Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws.

摘要

背景

机动车碰撞和跌倒导致了大多数脊柱骨折,并随后造成严重残疾。

目的

确定脊柱骨折的发病率、病因及后果。

材料与方法

回顾性收集2007年11月至2009年12月在卡塔尔创伤外科收治的所有创伤性脊柱损伤患者的创伤登记数据库中的数据。

结果

在创伤外科收治的3712例患者中,442例(12%)受伤患者发生脊柱骨折,平均年龄为33.2±12岁。男女比例为11.6:1。机动车碰撞(36.5%)和高处坠落(19.3%)是颈椎损伤的主要原因(P = 0.001)。损伤严重程度评分在4至75分之间。19%的颈椎损伤病例同时伴有胸椎损伤(P = 0.04)。27%的腰椎损伤病例与胸椎损伤相关(P < 0.001)。33%的胸腰联合损伤病例与颈椎损伤相关(P < 0.001)。伴有神经功能缺损的损伤总比例为5.4%。53例脊柱骨折患者接受了手术治疗;其中14例伴有神经功能缺损。总体死亡率为5%。

结论

脊柱骨折在卡塔尔并不罕见。颈椎和胸椎损伤伴有神经功能缺损及其他脊柱节段损伤的发生率最高。年轻男性是最易受影响的人群,在工作场所的 injury prevention programs 和交通法规执行方面应更加强调预防损伤。 (注:injury prevention programs 直译为“伤害预防计划”,这里可能结合语境意译为“预防损伤措施”更合适,但按要求未做调整)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5629/3519044/78cf13158b82/JETS-5-316-g003.jpg

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