【摘要】 目的　探讨胸腰段脊柱脊髓伤合并胸腹脏器伤的诊断和治疗。　方法　回顾性分析我院 1986年 1月-2002年 12月收治的此类伤 84例。其中胸椎骨折(T6 ~T12 )52例,腰椎骨折32例(L1 ~L4 ),合并胸部损伤 70例,合并腹部损伤 14例,合并颅脑、四肢骨盆损伤 34例。脊柱固定脊髓减压手术 62例,胸腔引流术 22例,剖腹手术 10例,开颅手术 9例。　结果　本组生存 82例,随访 6~36个月。神经功能恢复情况按Frankel标准:A级 36例中部分或感觉恢复 10例,其余神经功能均比术前改善 1~3级。延误诊断及漏诊 7例(12% ), 2例死于术后多器官功能障碍综合征(MODS)。　结论　对胸腰段脊柱脊髓伤合并胸腹脏器伤的患者应全面仔细地体检及X线或CT检查。救治应优先处理危及生命的胸腹伤,同时避免加重脊柱脊髓损伤。更多还原

【Abstract】 Objective To explore diagnosis and treatment of thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury. Methods A retrospective study was performed on 84 cases with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injuries treated in our unit from January 1986 to December 2002, of which there were 52 cases with thoracic vertebra fracture (T₆-T₁₂), 32 with lumbar fracture （L₁-L₄）, 70 with complicated chest injury, 14 with abdominal injury and 34 with injuries of cranium, extremities and pelvis. Spinal fixation or decompression of spinal cord was performed in 62 cases, drainage in 22, laparotomy in 10 and exploration of skull in nine. Results Eighty-two cases survived, with follow up period for 6-36 months. According to Frankel standard nerve function recovery showed that among 36 cases at grade A, 10 had partial or sensation recovery and the other got nerve function improvement for gradeⅠ-Ⅲ. Delayed diagnosis and missed injuries totaled seven cases （12%）. Two cases were died of postoperative MODS. Conclusions As for patients with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury, a comprehensive clinical examination including X-ray or CT is necessary. The treatment should first focus on thoracoabdominal viscera trauma and try to avoid aggravation of spine and spinal cord injury.更多还原