Czorlich Patrick, Burkhardt Till, Buhk Jan Hendrik, Matschke Jakob, Dreimann Marc, Schmidt Nils Ole, Eicker Sven Oliver
Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Diagnostic and Interventional Neuroradiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Eur Spine J. 2016 May;25(5):1349-1354. doi: 10.1007/s00586-016-4381-z. Epub 2016 Jan 14.
It is undisputed for more than 200 years that the use of a parachute prevents major trauma when falling from a great height. Nevertheless up to date no prospective randomised controlled trial has proven the superiority in preventing trauma when falling from a great height instead of a free fall. The aim of this prospective randomised controlled trial was to prove the effectiveness of a parachute when falling from great height.
In this prospective randomised-controlled trial a commercially acquirable rag doll was prepared for the purposes of the study design as in accordance to the Declaration of Helsinki, the participation of human beings in this trial was impossible. Twenty-five falls were performed with a parachute compatible to the height and weight of the doll. In the control group, another 25 falls were realised without a parachute. The main outcome measures were the rate of head injury; cervical, thoracic, lumbar, and pelvic fractures; and pneumothoraxes, hepatic, spleen, and bladder injuries in the control and parachute groups. An interdisciplinary team consisting of a specialised trauma surgeon, two neurosurgeons, and a coroner examined the rag doll for injuries. Additionally, whole-body computed tomography scans were performed to identify the injuries.
All 50 falls-25 with the use of a parachute, 25 without a parachute-were successfully performed. Head injuries (right hemisphere p = 0.008, left hemisphere p = 0.004), cervical trauma (p < 0.001), thoracic trauma (p < 0.001), lumbar trauma (p < 0.001), pelvic trauma (p < 0.001), and hepatic, spleen, and bladder injures (p < 0.001) occurred more often in the control group. Only the pneumothoraxes showed no statistically significant difference between the control and parachute groups.
A parachute is an effective tool to prevent major trauma when falling from a great height.
200多年来,使用降落伞可防止从高处坠落时发生严重创伤这一点毫无争议。然而,迄今为止,尚无前瞻性随机对照试验证明从高处坠落时使用降落伞而非自由落体在预防创伤方面具有优越性。这项前瞻性随机对照试验的目的是证明从高处坠落时降落伞的有效性。
在这项前瞻性随机对照试验中,按照赫尔辛基宣言,为研究设计准备了一个可从市场购得的人体模型玩偶,因为不可能让人类参与该试验。使用与玩偶身高和体重相匹配的降落伞进行了25次坠落试验。在对照组中,另外进行了25次不使用降落伞的坠落试验。主要观察指标是对照组和降落伞组的头部受伤率、颈椎、胸椎、腰椎和骨盆骨折发生率、气胸、肝、脾和膀胱损伤发生率。一个由专业创伤外科医生、两名神经外科医生和一名验尸官组成的跨学科团队检查了玩偶的受伤情况。此外,还进行了全身计算机断层扫描以确定损伤情况。
所有50次坠落试验——25次使用降落伞,25次不使用降落伞——均成功完成。对照组中头部受伤(右半球p = 0.008,左半球p = 0.004)、颈椎创伤(p < 0.001)、胸椎创伤(p < 0.001)、腰椎创伤(p < 0.001)、骨盆创伤(p < 0.001)以及肝、脾和膀胱损伤(p < 0.001)更为常见。只有气胸在对照组和降落伞组之间没有统计学上的显著差异。
降落伞是防止从高处坠落时发生严重创伤的有效工具。