外伤性颅脑损伤患者并发脊柱损伤:7年回顾性分析。

Wenye He, Jun Pan
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摘要

背景:评估外伤性头部损伤患者的脊髓损伤是至关重要的,因为它们有可能改变功能并增加死亡率。本研究旨在了解2015年4月至2022年4月成人外伤性颅脑损伤并发脊髓损伤的患病率及特点。材料和方法本研究纳入了1501例外伤性头部损伤成年患者的人口学、临床、创伤学和血流动力学数据。脊髓损伤是通过症状、体征和放射学表现来确定的。结果在研究期间,179例(12%)患者报告了相关的脊柱损伤。这些患者以男性为主(p=0.0012),年龄在65岁及以上(p=0.0452),有胸部损伤(p=0.0004),创伤后3小时以上到达急诊科(p=0.0004)。大多数伤害是由机动车事故(p=0.0412)或从大于3米的高度坠落(p=0.0481)造成的。此外,这些患者具有较高的简略损伤量表评分(≥2,p=0.0391), Eppendorf-Cologne量表评分(≥2,p=0.0412),较低的收缩压和舒张压读数(p=0.0481, p=0.0412)以及较低的心率(p=0.0482)。然而,脊柱损伤患者的收缩压和舒张压与年龄之间没有相关性。结论外伤性颅脑损伤患者脊柱损伤的发生率和严重程度不仅受人口统计学和临床参数的影响,还受颅脑损伤程度和程度的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Concurrent Spinal Trauma in Patients with Traumatic Head Injury: A Seven-Year Retrospective Analysis.

BACKGROUND Assessing spinal injuries in patients with traumatic head injuries is crucial due to their potential to alter functionality and increase mortality rates. This single-center retrospective study was conducted to understand the prevalence and characteristics of concurrent spinal injuries in adults with traumatic head injury from April 2015 to April 2022. MATERIAL AND METHODS The study incorporated demographic, clinical, traumatological, and hemodynamic data from 1,501 adult patients presenting with traumatic head injuries. Spinal injuries were identified through symptoms, physical signs, and radiological findings. RESULTS During the study period, 179 patients (12%) were reported with associated spinal injuries. These patients were predominantly male (p=0.0012), aged 65 years or above (p=0.0452), had thoracic injuries (p=0.0004), and arrived at the emergency department more than three hours post-trauma (p=0.0004). Most injuries were caused by motor vehicle accidents (p=0.0412) or falls from heights greater than 3 meters (p=0.0481). In addition, these patients had higher Abbreviated Injury Scale scores (≥2, p=0.0391), Eppendorf-Cologne Scale scores (≥2, p=0.0412), and lower systolic and diastolic blood pressure readings (p=0.0481, p=0.0412) along with lower heart rates (p=0.0482). However, no correlation was found between systolic and diastolic pressures and age among patients with spinal injuries. CONCLUSIONS This study reveals that the prevalence and severity of spinal injuries in patients with traumatic head injuries are influenced not only by demographic and clinical parameters, but also by the degree and extent of head trauma.

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