汶川地震中脊柱骨折伤员的救治体会.DOCVIP

临床医学论文-汶川地震中脊柱骨折伤员的救治体会 ???????????????作者：潘显明，邓少林，屈波，蒋凯，李伟，邱小波，权毅? 【摘要】? ［目的］分析汶川地震后脊柱骨折伤员的临床特点及救治经验。［方法］分析整理本科94例地震脊柱骨折伤员的临床资料，包括一般情况、受伤机制、合并伤情况及救治措施。［结果］在所有脊柱骨折伤员中，男性伤员的发病率明显高于女性伤员，21～60岁年龄段为脊柱骨折高发年龄段。同时，脊柱骨折的合并伤有54例，占57.4％。脊柱骨折分型显示屈曲压缩性骨折及爆裂型骨折共89例，占94.7％。［结论］地震伤脊柱骨折的伤员数量较大，送达时间集中，损伤严重，合并伤多，因而，科学组织，合理分工，可以在短时间内完成大批伤员的及时治疗。 【关键词】? 地震； 脊柱骨折； 性别； 年龄 ??? Abstract：［Objective］To analyze the clinical features of spinal fracture of the injured in Wenchuan Earthquake and to summarize the medical rescue.［Method］The clinical data of 94 injured cases with spinal fracture in the earthquake were collected and analyzed,including the general condition,injury mechanism,associated injuries and the rescue measures.［Result］The incident rate of the male was much higher than that of the female,the incidence of spinal fracture was high in 21～60years old; the associated injuries were found in 54 cases,taking up 57.4%.The spinal fracture typing showed that 89 cases had flexion-compression fracture and burst fracture,taking up 94.7%.［Conclusion］Earthquakes cause a large amount of the injured with spinal fracture,who are evacuated within a concentrated time,the injuries are severe with many associated injuries.Scientific organization and reasonable division are critical in the immediate medical rescue of the injured in large quantity within the shortest time. ??? Key words：earthquake;? spinal fracture;? sex;? age ???? 2008年5月12日14时28分发生在四川汶川的里氏8.0级特大地震造成了大量的人员伤亡。本院共收治地震伤员1 270人，是灾区收治地震伤员最多的一家医院。收治骨科伤员715人，其中脊柱骨折伤员94例，占全部地震伤员的7.4％，占骨科伤员的13.1％。在大批量伤员集中送达医院的特殊情况下，对这些患者中脊柱骨折的救治进行总结分析，能更好地了解地震伤脊柱骨折发病特点，为以后在类似灾难中的伤员救治提供有益的经验，具体报道如下。 ??? 1? 临床资料 ??? 1.1? 一般资料 ??? 94例脊柱骨折患者，男54例，女40例；年龄6～96岁，平均49.6岁，21～60岁的伤员有66例，占70.2％；城市伤员28例，占29.8％，农村伤员68例，占72.3％。具体年龄分布见表1。94例患者中，合并多发伤54例，其中四肢骨折17例，骨盆骨折4例，根据Tile分型全部为A型［1］，采用保守治疗，挤压伤1例，合并右下肢毁损伤1例，行右大腿中段截肢术；肋骨骨折6例，软组织伤18例，胸部外伤5例，膀胱破裂及尿道断裂1例，肠破裂1例；全部伤员中合并全瘫患者5例，不全瘫者23例，入院后无死亡病例；受伤部位：颈椎骨折2例，单纯腰椎骨折61例，单纯胸椎骨折21例，胸腰椎跳跃性骨折10例，均无瘫痪；按骨折类型分类：屈曲压缩骨折57例，爆裂骨折32例，屈曲牵张型损伤3例，