多发伤中胸腰椎骨折误诊漏诊原因分析

目的　分析多发伤病例胸腰椎骨折的误诊漏诊原因。方法　通过对 1 4 7例多发伤合并胸腰椎骨折临床资料的回顾性分析 ,研究误诊漏诊的原因。结果　 2 8例胸腰椎骨折被误诊漏诊 ,占 1 9%。原因包括病情危重、读片失误和病情较稳定但未行X线检查。结论　对于多发伤患者应进行详细全面的脊柱物理检查 ,有阳性发现时应行X线检查 ,对于所有胸腰椎骨折或怀疑有胸腰椎骨折患者均应行CT扫描检查

Causes of Delayed Diagnosis of Thoracolumbar Fractures in Multiple Injured Patients

Objective To analyze the causes of delayed diagnosis of thoracolumbar fractures in multiple injured patients.Methods One hundred forty-seven patients with multitrauma and thoracolumbar fractures were retrospcectively reviewed to determine the incidence and causes of delayed diagnosis of thoracolumbar fractures.Results There was a delay in diagnosis of thoracolumbar fractures for 28 patients,representing 19% of all the cases of thoracolumbar fractures.The causes of delayed diagnosis included critical status of the patients,mistakes on reading radiographs and no radiography although the patients were stable.Conclusion A through and systematic examination is necessary for the patients with multitrauma.If there is any positive finding as to the clinical examination,further radiographic studies of the thoracolumbar spine should be performed.Routine CT scan should be recommended for all patients with or suspected of thoracolumbar injuries.