颈椎过伸伤伴脊髓损伤同头面部损伤位置的相关性  

Correlation of head face damage location with spinal cord injury in patients with cervical vertebra hyperextension injury

作　　者：谭俊铭 申练兵 王朝阳 姜军松 邢顺民 陈德纯 时国华 廖腾 苏加向 何翔 来津 王金鑫 张颉峰 

机构地区：[1]解放军第九八医院全军创伤修复重建中心,浙江省湖州市313000 [2]解放军第九八医院颌面外科,浙江省湖州市313000

出　　处：《实用医学杂志》2013年第12期1933-1935,共3页The Journal of Practical Medicine

基　　金：中国人民解放军全军"十二五"科研面上课题(编号:CWS11J260);南京军区医学创新重点课题(编号:08Z003)

摘　　要：目的:研究不同面部损伤位置对于颈椎过伸伤患者是否发生脊髓损伤的影响。方法:选择2006年4月至2010年3月间我院收治的颈椎过伸伤患者52例,按头面部损伤部位的不同将患者分为3组,其中前额组16例、面部组25例、下颌组11例。本组52例患者均手术治疗,采用Frankekl分级和JOA评分对患者术前和术后的脊髓神经功能进行评估。结果:前额组:C42例,C55例,C65例,C73例,C31例;面部组:C513例,C68例,C74例;下颌组:C55例,C65例,C71例。不同组间脊髓损伤部位差异不具有统计学差异(P>0.05);术后Frankel分级前额组患者C级2例,D级6例,E级8例;面部组患者C级6例,D级8例,E级1例;下颌组患者B级3例,D级6例,E级2例。不同组间患者恢复情况比较差异具有显著性(P<0.05)。结论:头面部损伤位置同颈椎过伸伤患者脊髓损伤情况无明显影响,但下颌部损伤较面部和前额部损伤的患者脊髓神经更难以恢复。Objective To investigate the effects of face damage location on spinal cord injury in patients with cervical vertebra hypertension injury. Methods From Apr 2006 to Mar 2010, 52 patients with cervical hyperextension injury were divided into 3 groups according to the different parts of head face damage： forehead group （n = 16）, facial group （n = 25） and mandibular group （n = 11 ）. All 52 patients received surgical treatment. Spinal cord neural function was evaluated by Frankel classification and JOA score. Results The sites of spinal cord injury in forehead group were： 1 case in Ca, 2 cases in C4, 5 in C5, 5 in C6, 3 in C7; those in facial group were：13 cases in C5, 8 in C6, 4 in C7; those in mandibular group were： 5 cases in C5, 5 in C6, 1 in C7; and there was no significant difference of spinal cord injury sites among the three groups （P 〉 0.05 ）. After surgical treatment, the Frankel classifications in forehead group were ： 2 cases with grade C, 6 with grade D, 8 with grade E ; those in facial group were： 6 cases with grade C, 8 with grade D, 1 with grade E; and those in mandibular group were： 3 eases with grade B, 6 with grade D, 2 with grade E. The recovery of patients in different groups was different （P 〈 0.05）. Conclusion The location of head face damage was not correlated with cervical hyperextension injury in patients with cervical hyperextension injury; but the spinal cord function in patients with mandibular injury was more difficult to recover than those with facial or forehead injury.

关 键 词：脊髓损伤 颈椎过伸伤 头面部损伤 

分 类 号：R687.3[医药卫生—骨科学]