交通伤致颈椎挥鞭样损伤的急诊诊治

目的 总结交通伤致颈椎挥鞭样损伤的临床特点,为急诊诊治提供参考.方法 对2002年1月至2008年12月急诊收治的交通伤所致的263例颈椎挥鞭样损伤患者的临床表现、影像学检查结果和急诊早期处理方法进行回顾性分析总结.结果 该损伤临床表现呈多样性,以颈肩枕部疼痛不适和压痛最常见,多数患者伤后数小时内出现症状,但约1/3患者症状迟发;影像学检查中,X线片阳性结果最低,CT和MRI阳性结果高;222例保守治疗和41例手术治疗的患者,经平均7.2个月随访总体治疗效果满意.结论 根据交通事故中驾乘人员易出现颈椎挥鞭样损伤的创伤条件,结合临床表现可以对其进行早期诊断、及时治疗,多数预后较好,综合应用影像学检查町避免漏诊,CT检查可以作为诊断的重要手段.

Emergency diagnosis and treatment of whiplash injury to cervical spinal cord caused by traffic accidents

Objective To summarize the clinical features of whiplash injury to the cervical spine caused bv traffic accident for the emergency diagnosis and treatment. Methods Two hundred and sixty-three drives and passengers with whiplash injury caused by a road accident were reviewed.The clinical manifestations,imaging examinations,and early emergency treatments of the injury were analyzed. Results Among its many clinical manifestations,neck pain and tenderness was the common symptom,emerging within several hours after the injury.However,the clinical manifestations were delayed in about 1/3 cases.The positive results of X-ray films were much lower compared with CT and MRI.Followups for a mean of 7.2 months revealed 222 satisfactory conservative cases and 41 satisfactory operative cases. Conclusions The whiplash injury can be diagnosed and treated early according to the clinical manifestations and likely conditions in the traffic accident.The prognosis can be fine in most cases.Different imaging examinations,especially CT,can reduce misdiagnosis.