院前脊柱固定：脊柱活动限制与脊柱固定的神经学结局
Pre-Hospital Spinal Immobilization: Neurological Outcomes for Spinal Motion Restriction Versus Spinal Immobilization.
作者信息
Nilhas Aaron, Helmer Stephen D, Drake Rachel M, Reyes Jared, Morriss Megan, Haan James M
机构信息
Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS.
Department of Trauma Services, Ascension Via Christi Hospital Saint Francis, Wichita, KS.
出版信息
Kans J Med. 2022 Apr 29;15(1):119-122. doi: 10.17161/kjm.vol15.16213. eCollection 2022.
INTRODUCTION
New recommendations for emergency medical services spinal precautions limit long spinal board use to extrication purposes only and are to be removed immediately. Outcomes for spinal motion restriction against spinal immobilization were studied.
METHODS
A retrospective chart review of trauma patients was conducted over a six-month period at a level I trauma center. Injury severity details and neurologic assessments were collected on 277 patients.
RESULTS
Upon arrival, 25 (9.0%) patients had a spine board in place. Patients placed on spine boards were more likely to be moderately or severely injured [injury severity score (ISS) > 15: 36.0% vs. 9.9%, p = 0.001] and more likely to have neurological deficits documented by emergency medical services (EMS; 30.4% vs. 8.8%, p = 0.01) and the trauma team (29.2% vs. 10.9%, p = 0.02).
CONCLUSIONS
This study suggested that the long spine board was being used properly for more critically injured patients. Further research is needed to compare neurological outcomes using a larger sample size and more consistent documentation.
引言
紧急医疗服务脊柱防护的新建议将长脊柱板的使用限制在仅用于解救目的，并且应立即移除。对脊柱活动限制与脊柱固定的结果进行了研究。
方法
在一家一级创伤中心对创伤患者进行了为期六个月的回顾性病历审查。收集了277例患者的损伤严重程度细节和神经学评估。
结果
到达时，25例（9.0%）患者使用了脊柱板。使用脊柱板的患者更有可能受到中度或重度损伤[损伤严重程度评分（ISS）>15：36.0%对9.9%，p = 0.001]，并且更有可能有紧急医疗服务（EMS；30.4%对8.8%，p = 0.01）和创伤团队记录的神经功能缺损（29.2%对10.9%，p = 0.02）。
结论
本研究表明，长脊柱板正被正确用于伤势更严重的患者。需要进一步研究以使用更大样本量和更一致的记录来比较神经学结果。
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