颈脊髓损伤为主严重多发伤的伤害控制(附32例报告)

[目的]探讨伤害控制原则在颈脊髓损伤为主严重多发伤救治中的临床应用。[方法]回顾性分析32例颈脊髓损伤为主严重多发伤患者临床治疗资料，颈椎骨折并截瘫18例，外伤性颈椎间盘突出并高位截瘫2例，颈椎骨折脱位并截瘫12例。神经功能评定按ASIA分级。[结果]31例获得平均14个月随访。29例颈椎骨折愈合，神经症状10例完全恢复，13例有Ⅰ级以上恢复，8例无变化。死亡1例。[结论]颈脊髓损伤为主严重多发伤急诊遵循伤害控制原则，待病情稳定后7—10d内安全地进行最终手术，可提高救治成功率。

Damage control of severe cervical core injury in patients complicated with polytrauma

[ Objective ] To explore the strategy of damage control in clinic treatment of severe cervical core injury in patients with polytrauma. [ Method ] A retrospective analysis was performed to analyze 32 patients about characteristics and treatments. There were 18 patients with cervical fractassociated paraplegina, 2 patients with traumatic intervertebral disk hernia associated with high paraplegia, 12 patients with cervical fractures and dislocation associated with high paraplegia. ASIA grading system was carried out. [ Result]Thirty-one patients were followed up for an average of 14 months in this group. Of the 3t patients with neurological deficit, 10 got complete recovery, 13 experienced improvement of more than one ASIA grade,and 8 experienced no improvement, one a patient died . [ Conclusion ] For the emergency treatment of cervical core injury in patients with severe polytrauma,the damage control stragtery is the principle to be followed, the final operations may be applied from 7th to lOth day safely, all these help raise the achievment ratio of remedy.