车祸伤致脊柱骨折临床特点分析

Clinical features of spinal fractures resulting from motor vehicle collisions

目的分析车祸伤致脊柱骨折的临床特点,以提高车祸伤致脊柱骨折的预防及救治水平。方法总结沈阳军区总医院骨科自2006年1月至2016年1月收治的166例脊柱骨折患者的临床资料,并进行流行病学统计分析。结果本组166例患者,年龄分布主要集中在40~59岁,占50.0%（83/166）。驾驶员是主要致伤身份,占48.2%（80/166）。235个损伤节段中,颈椎、胸椎、腰椎及骶尾椎损伤所占比例依次为40.9%（96/235）、30.2%（71/235）、28.1%（66/235）、0.9%（2/235）,其中,L1、C2、T12分别为17.0%（40/235）、14.0%（33/235）、12.3%（29/235）。合并症及神经损伤发生率在年龄≤19岁组最高,分别为50.0%和50.0%。行人组的合并症发生率最高为43.5%,驾驶员组的神经损伤发生率最高为55.0%。结论由车祸伤致脊柱骨折的流行病学特点可见,驾驶员是主要车祸伤来源,根据车祸时的身份不同,神经损伤和合并症发生情况有所不同,应根据其特点进行防治。

Objective To analyze the epidemiologic features of traumatic spinal fracture resulting from motor vehicle collisions in order to improve their prevention and surgical treatment. Methods A review of 166 cases（ 120 males,46 females） of spinal fractures was performed to analyze their epidemiology statistically. Their ages ranged from 4 to 75 years,with a mean value of 39. 8 years. Results The 40 to 59 year-old patients formed the largest group,accounting for about 50. 0%（ 83 /166）. Drivers were the main causes for the traumatic fracture,accounting for about 48. 2%（ 80 /166）. Cervical,thoracic,lumbar,sacrum and coccyx fracture accounted for40. 9%（ 96 /235）,30. 2%（ 71 /235）,28. 1%（ 66 /235）,0. 9%（ 2 /235）,respectively. The rates of fracture in L1,C2 and T12 were17. 0%（ 40 /235）,14. 0%（ 33 /235）,12. 3%（ 29 /235）,respectively. Age≤19 years patients presented with the highest rate of associated injury（ 50. 0%） and spinal cord injury（ 50. 0%）. Pedestrian presented with the highest rate of associated injury（ 43. 5%） and drivers presented with the highest rate of spinal cord injury（ 55. 0%）. Conclusion The epidemiological survey of traumatic spinal fracture resulting from motor vehicle collisions reveals that drivers were the main factors for injuries of spinal fracture. Different characteristics of associated injury and spinal cord injury according to different role,the prevention and treatment should be designed according to the injury features of different individuals.