胸椎骨折合并胸骨骨折临床治疗.docVIP

胸椎骨折合并胸骨骨折临床治疗【摘要】 目的：探讨胸椎骨折合并胸骨骨折的临床治疗方法。方法：采用自行设计表，对自2004年8月至2010 年11月,我院收治的胸椎骨折合并胸骨骨折患者共17例进行回顾性分析, 全部病例均行X 线、 CT 及MRI检查。14例行手术治疗，3例因经济原因采用保守治疗。结果：17组病例就诊后 2 4 h内即明确诊断者17例 (100％).14例行手术治疗的患者，明显好转12例( 85.7％)，有一定好转2例(14.3％)，无效 0例(0％)， 有效率100％。而保守治疗的患者，明显好转0例，有一定好转 1 例( 33.3％)，无效2例( 66.7％)，有效率33.3 ％。结论：胸椎骨折合并胸骨骨折的临床特点为致伤暴力强大, 脊柱骨折、脊髓损伤严重，合并多发伤发生率高，因此治疗选择尽量为手术治疗，手术的目的在于稳定脊柱并使脊髓得到减压防止进一步恶化。 【关键词】 胸椎骨折；胸骨骨折；临床治疗 Fracture of thoracic clinical treatment of sternum fracture Bai Qingling (People’s Hospital in Yunnan Province, Yunnan Baoshan 678000) 【Abstract】Objective: Fracture of thoracic sternum fracture treatment. Methods: A self-designed form, for self-August 2004 to November 2010, our hospital sternal fracture with thoracic spine fracture patients were retrospectively analyzed 17 patients, all patients underwent X ray, CT and MRI. Surgical treatment of 14 cases, 3 cases with conservative treatment because of economic reasons. Results: The 17 treatment group of patients within 2 4 h after the diagnosis in 17 cases (100%) .14 patients underwent surgical treatment, significantly improved in 12 patients (85.7%), a certain improvement in 2 cases (14.3%), invalid 0 cases (0%), efficiency 100%. The conservative treatment of patients, significant improvement in 0 cases, a certain improvement in 1 case (33.3%), 2 cases (66.7%) was 33.3%. Conclusions: Fracture of thoracic sternum fracture is characterized by great violence, injury, spinal fractures, spinal cord injury severity, the high incidence of multiple injuries combined, so treatment options, as far as surgical treatment, surgery aims to stabilize the spine and to be decompression of spinal cord prevent further deterioration. 【Key words】 thoracic fractures; sternum fracture; clinical treatment 胸椎骨折伴发胸骨骨折很少见，大多由强大的暴力所引致，常合并其他损伤，国内外报道较少。在严重的创伤中才可能发生胸椎骨折合并胸骨骨折，胸椎因其解剖结构的特殊性,其损伤的原因、 特点及治疗与其他部位的脊柱骨折都有所不同。而且这类合并伤往往伴有多根肋骨前端骨折，影响胸廓的呼吸运动。大多数伤员伴有胸内脏器创伤或胸椎压缩骨折，伤情严重。胸骨骨折可发生在胸骨柄、胸骨体或剑突。大多为横断骨折。骨折后下 段胸骨可向前或向后移位，局部剧烈