本文選題：顱腦損傷 + 頸椎損傷��； 參考：《中國矯形外科雜志》2017年20期

【摘要】：[目的]總結(jié)輕中型顱腦損傷合并上頸椎骨折的手術(shù)治療經(jīng)驗,以提高對顱頸聯(lián)合傷的認(rèn)識。[方法]2008年6月~2012年6月本院手術(shù)治療顱腦損傷合并上頸椎骨折患者46例,對其中無頸髓損傷的22例進行回顧性分析,男13例,女9例,年齡23~68歲,平均41歲。致傷原因:交通傷12例,高處墜落傷7例,暴力及其他傷3例,進行格拉斯哥預(yù)后評分(GOS),術(shù)后隨訪X線或CT片評價骨折愈合、植骨融合及頸椎穩(wěn)定性情況。[結(jié)果]入院格拉斯哥評分(GCS)12~14分10例,9~11分12例。均有不同程度腦挫裂傷、硬膜外血腫、硬膜下血腫、腦內(nèi)血腫;其中合并齒突骨折7例,Jefferson骨折5例,樞椎椎弓骨折4例;寰樞椎復(fù)合骨折6例。早期頸椎骨折漏診3例。12例顱內(nèi)血腫行開顱手術(shù),3例一期聯(lián)合頸椎手術(shù),19例二期行頸椎手術(shù)。22例均行手術(shù)治療,術(shù)中無明顯并發(fā)癥。隨訪12~36個月,平均18個月。出院GOSⅣ級3例,Ⅴ級19例,枕部放射痛、頸部活動受限等臨床癥狀均減輕,術(shù)后復(fù)查X線片示骨折愈合良好,頸椎穩(wěn)定,無內(nèi)固定松動、脫出及斷裂。[結(jié)論]顱頸聯(lián)合傷在臨床上并不少見,應(yīng)重視顱腦損傷患者的頸部檢查及保護。早期腦外科與骨科同臺手術(shù)可取得較好的療效。
[Abstract]:Objective: to summarize the experience of surgical treatment of mild and moderate craniocerebral injury combined with fracture of upper cervical vertebra in order to improve the understanding of combined craniocervical injury. [methods] from June 2008 to June 2012, 46 cases of craniocerebral injury complicated with fracture of upper cervical vertebra were treated by operation in our hospital. Among them, 22 cases without cervical spinal cord injury were analyzed retrospectively. There were 13 males and 9 females, aged 2368 years, with an average age of 41 years. The causes of injury included traffic injury (n = 12), falling injury (n = 7), violence and other injuries (n = 3). Glasgow prognosis score (GOS) was used to evaluate fracture healing, bone graft fusion and cervical spine stability. [results] Glasgow score (GCS) was 12 ~ 14 in 10 cases and 9 ~ 11 in 12 cases. There were different degrees of cerebral contusion, epidural hematoma, subdural hematoma and intracerebral hematoma, including 7 cases with dentoid process fracture, 5 cases with Jefferson fracture, 4 cases with axial arch fracture and 6 cases with atlantoaxial complex fracture. 3 cases of early cervical fracture missed diagnosis. 12 cases of intracranial hematoma underwent craniotomy 3 cases combined with cervical surgery in 19 cases. 22 cases were treated with cervical surgery without obvious complications. The follow-up was 12 ~ 36 months (mean 18 months). The clinical symptoms such as occipital radiation pain and limited cervical movement were relieved in 3 cases of GOS 鈪，

本文編號：2076799