重型颅脑损伤合并颈椎颈髓损伤的早期诊断体会

Diagnosis of severe craniocerebral injury complicated with cervical spine injury

目的探讨重型颅脑损伤合并颈椎颈髓损伤早期诊断的临床指导意义。方法回顾性分析36例颅脑损伤合并颈椎颈髓损伤临床资料,根据入院后确诊合并颈椎颈髓损伤时间分为两组,早期组(≤24小时)22例,对照组(>24小时)14例,观察比较两组之间死亡率、远期生活质量评估(KPS)评分差别并进行总结归纳。结果早期诊断组积极采取有效措施预防及处理并发症,两组死亡率比较,P>0.05,无统计学意义,KPS统计学比较,P<0.05,有统计学意义。结论提高重型颅脑损伤合并的颈椎颈髓损伤的早期诊治率可望提高伤员的远期预后好转率、救治成功率,降低残死率。

Ojbective To discuss the clinical significance of early diagnosis in severe head injury with cervical spinal cord injury.Methods Retrospective analysis of head injury combined with cervical spine（spinal cord） injury was conducted in 36 patients,who were divided into the early group（≤ 24 hours,22 cases） and the control group（24 hours,14 cases） on the basis of diagnosis time.Mortality and Karnofsky Performance Scale were compared between the two groups.Results Measures were effectively taken to prevent and deal with complications in the early group.There was no statistical difference in the mortality between the two groups（P0.05）,but statistical difference in the KPS（P0.05）.Conclusion Improving the rate of early diagnosis and treatment could enhance the recovery rate of long-term prognosis,successful treatment rate and reduce the disability rate and death rate.