Omori Kazuhiko, Jitsuiki Kei, Majima Takashi, Takeuchi Ikuto, Yoshizaw Toshihiko, Ishikawa Kouhei, Ohsaka Hiromichi, Tambara Keiichi, Yanagawa Youichi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University.
Department of Cardiovascular Surgery, Shizuoka Hospital, Juntendo University.
Int J Sports Phys Ther. 2017 Jun;12(3):390-401.
A 64-year-old male fell from an altitude of 10 m while paragliding after stalling due to the wind. The purpose of this case report is to describe the outcomes after multiple injuries sustained during a paragliding accident, including a potentially life-threating injury to the thoracic aorta. The subject sustained a bite wound on his tongue, injuries to his chest (left side) and back, and a right forearm deformity. Enhanced whole body computed tomography (CT) revealed fractures of the bilateral laminae of the second and third cervical bones, right first rib, the tenth thoracic vertebral body (compression type), second lumbar vertebral body (burst type) and the right radius, Other injuries included an injury to the thoracic aortic arch and the presence of intraabdominal fluid collection without perforation of the digestive tract. Endovascular treatment was selected for the aortic injury because of multiple injuries. Immediate management included hypotensive rate control therapy using calcium and a beta blocker. On the fourth hospital day, the subject underwent deployment of a stent-graft to the aorta and subsequent surgical immobilization for the lumbar burst fracture. He also underwent surgical immobilization of the radial fracture and was discharged on the 28th hospital day. First responders or physicians should consider the possibility of aortic injury when treating patients who suffer falls while paragliding and provide appropriate management. Failure to provide appropriate management of an aortic injury could result in death.
一名64岁男性在滑翔伞飞行时因风力失速从10米高空坠落。本病例报告的目的是描述滑翔伞事故中多处受伤后的结果,包括对胸主动脉的潜在致命伤。该患者舌头咬伤、胸部(左侧)和背部受伤以及右前臂畸形。增强型全身计算机断层扫描(CT)显示第二和第三颈椎双侧椎板骨折、右侧第一肋骨骨折、第十胸椎椎体骨折(压缩型)、第二腰椎椎体骨折(爆裂型)以及右侧桡骨骨折。其他损伤包括胸主动脉弓损伤和腹腔积液但无消化道穿孔。由于多处受伤,对主动脉损伤选择了血管内治疗。立即处理包括使用钙剂和β受体阻滞剂进行降压心率控制治疗。在住院第四天,患者接受了主动脉支架植入术,随后对腰椎爆裂骨折进行了手术固定。他还接受了桡骨骨折的手术固定,并于住院第28天出院。急救人员或医生在治疗滑翔伞坠落患者时应考虑主动脉损伤的可能性并提供适当处理。未能对主动脉损伤进行适当处理可能导致死亡。
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