高速公路交通事故致脊柱损伤的初步报告

Vertebral column injuries induced by highway traffic accidents

目的 分析高速公路交通事故致脊柱损伤的基本特点。方法 通过流行病学调查收集 1990～ 1996年沈大高速公路交通伤中脊柱损伤伤员的基本资料并分析。结果 在 116 1人次伤员中共有脊柱损伤 92例 (7 9% ) ,其中颈椎损伤 5 7例 ,胸腰椎损伤 35例。脊柱损伤中83 7%为多发伤 ,颈椎损伤多合并颅脑外伤 ,胸腰椎损伤则多合并胸腹部脏器外伤。 92例脊柱损伤中死亡 5 0例 (5 4 3 % ) ,截瘫 2 3例 (2 5 0 % ) ,痊愈者仅 19例 (2 0 7% )。其中颈椎损伤者死亡率为 77 2 % (4 4/ 5 7) ,胸腰椎损伤者死亡率为 17 1% (6 / 35 )。本研究对比分析了交通事故类型与脊柱损伤的关系 ,及车内人员不同座位与脊柱损伤的关系。结果提示颈椎损伤伤员中驾驶员的构成比明显低于胸腰椎损伤伤员中驾驶员的构成比 (P <0 0 1)。结论 交通伤中脊柱损伤的普遍性、损伤的复杂性及不良预后应得到足够的重视。

Objective To evaluate the characteristics of vertebral column injuries induced by highway traffic accidents. Methods Through the epidemiological investigation,data of vertebral column injury were collected from all traffic accidents happened in Shenyang-Dalian Highway during the year 1990～1996.Results Ninety-two cases(7 9%) of vertebral column injuries were collected from a total of 1161 cases of traffic accidents,including 57 cases of cervical vertebral column injuries and 35 cases of thoracolumbar vertebral column injuries.83 7% of vertebral column injuries were multiple traumas.Craniocerebral injury occurred more common in cervical injuries while thoraco cardiac trauma and abdominal trauma were more common in thoracolumbar injuries.In 92 cases of all vertebral column injuries,50 cases died(54 3%),23 cases was paraplegic (25 0%),and only 19(20 7%) cases were cured.The mortality of cervical injuries was 77 2%(44/57),and that of thoracolumbar injuries was 17 1%(6/35).The relationship between the types of traffic accidents and vertebral column injuries and the relationship between the different seats in the vehicle and vertebral column injuries were also analyzed.It was suggested that the drivers suffer from thoracolumbar injuries more than cervical injuries(P<0 01).Conclusion In traffic accidents,attention should be paid to vertebral column injuries because of its morbidity,complicated in nature and poor prognosis.