上颈椎骨折合并轻中型颅脑损伤的手术策略选择体会及效果  

Experience and Effect of Surgical Strategy Selection for Upper Cervical Spine Fracture with Mild to Moderate Craniocerebral Injury

作　　者：刘旭臣 王延斌 邱志华 Xuchen LIU;Yanbin WANG;Zhihua QIU(Department of Orthopaedics,Guangdong Sanjiu Brain Hospital,Guangzhou Guangdong 510510,China;Department of Orthopaedics,Naval Medical Center,Shanghai 200052,China)

机构地区：[1]广东三九脑科医院骨科,广东广州510510 [2]海军特色医学中心骨科,上海200052

出　　处：《国际感染病学（电子版）》2019年第4期18-19,共2页Infection International(Electronic Edition)

摘　　要：目的总结上颈椎骨折合并轻中型颅脑损伤手术策略选择的体会及其治疗效果.方法以2018年6月-2019年6月本院收治的上颈椎骨折合并轻中型颅脑损伤患者36例为研究对象,对其手术治疗进行回顾性分析.结果36例患者颈椎手术均顺利完成,未出现因为颈椎骨折处理不到位导致患者脊髓受伤的情况,术后患者颈部活动受限、枕部放射性疼痛等症状均得到有效缓解.出院时患者GOS评分V级25例,IV级11例,未出现患者死亡的情况.患者复查结果显示,全部病例骨折均得到良好愈合,颈椎稳定,未出现固定断裂、松动及脱出的情况.早期颈椎骨折漏诊5例,漏诊率为13.89%(15/36).结论颈椎骨折联合颅脑损伤在临床上比较常见,对于颅脑损伤患者应重点对其颈部进行检查和保护,早期进行骨科、脑外科联合手术临床效果较好,上颈椎骨折则应尽早进行手术,不能过分强调颅脑损伤的治疗而延误颈椎手术的时机.Objective To summarize the experience of surgical strategy selection and therapeutic effect of upper cervical spine fracture combined with mild to moderate craniocerebral injury. Methods From June 2018 to June 2019, 36 patients with upper cervical spine fracture combined with mild to moderate craniocerebral injury were studied retrospectively. Results All 36 cases of cervical spine surgery were successfully completed, and there was no spinal cord injury caused by inadequate treatment of cervical spine fracture. The symptoms of cervical movement limitation and occipital radiation pain were effectively alleviated after operation. There were 25 patients with GOS grade V and 11 patients with IV grade at discharge, and no death occurred. The results of the patient’s reexamination showed that all the fractures healed well and the cervical spine was stable. There was no fracture, loosening or prolapse of the fixation. Early cervical spine fracture was missed in 5 cases, the missed diagnosis rate was 13.89%(15/36). Conclusion Cervical spine fracture combined with craniocerebral injury is common in clinic. For patients with craniocerebral injury, the focus should be on the examination and protection of their neck. Early combined surgery of orthopedics and brain surgery has a better clinical effect. For upper cervical spine fracture, surgery should be performed as soon as possible. The treatment of craniocerebral injury should not be overemphasized and the cervical hand should be delayed.Opportunity of operation.

关 键 词：上颈椎骨折 轻中型颅脑损伤 手术策略 

分 类 号：R68[医药卫生—骨科学]