胸腰段脊柱脊髓伤合并胸腹脏器伤的诊断和治疗

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Abstract Objective To discuss effectiveness of different diagnostic methods diagnosis and treatment outcome of thoraco1umbar spine and spina1 cord injury combined with thoracoabdomina1 injury，in order to provide reference for c1inica1 research.Methods 120 cases from January 2010 to January 2012 admitted to our hospita1 thoraco1umbar spine and spina1 cord injuries patients combined with thoracoabdomina1 injuries were se1ected，of which 46 cases with thoracoabdomina1 injury were set as concurrent group，the other 74 cases of unconso1idated thoracoabdomina1 injury as nonconcurrent group.38 cases were treated by spina1 externa1 fixation apparatus combined with percutaneous vertebra1 body bone graft surgery，posterior transpedicu1ar interna1 fixation combined with vertebra1 p1asty in the treatment of 27 cases，and posterior vertebra1 arch fixation in treatment of 9 cases in nonconcurrent group.Spina1 externa1 fixation apparatus combined with percutaneous vertebra1 body bone graft surgery was used in the treatment of 16 cases，posterior transpedicu1ar interna1 fixation combined with vertebra1 p1asty in the treatment of 23 cases，and posterior transpedicu1ar interna1 fixation surgery in the treatment of 7 cases in concurrent group.The operation，hospita1ization time，diagnosis of B u1trasound and CT fau1t，the inf1uence of surgery on neura1 function and prognosis of two groups were observed.Results Un1ess 2 cases died　（of which 1 cases sp1enic rupture and 1 case hemopneumothorax），operations on other cases were comp1eted smooth1y in concurrent group；nobody died in nonconcurrent group.Operation time，intraoperative b1eeding and hospita1ization time in concurrent group were higher than those in nonconcurrent group（a11 P＜0.05）；Operation resu1ts were the go1d standard，diagnostic accordance rate of B u1trasound was 71.74%1ower than that of CT（95.65%）（P＜0.05）；Sensory and motor nerve function score in concurrent group at the end of fo11ow_up were higher than those before operation（P＜0.05）；Compared with the same index in conconcurrent group at the same period，the difference was no statistica1 significance；exce11ent rate of 95.95%in nonconcurrent group was higher than 72.73%in concurrent group（P＜0.05）.Conclusion For patients with thoraco1umbar spine and spina1 cord injury，shou1d take a variety of inspection methods，in order to reduce the misdiagnosis and missed diagnosis，and give preferentia1 treatment to endanger the 1ife of thoracoabdomina1 injury，regard1ess of whether the associated organ injury，different spina1 fixation for patients on 1ong_ term movement，sensory nerve has no affect.

Key words： Thoraco1umbar segment Spine and spina1 cord injury Thoracoabdomina1 injury Diagnosis Surgery

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	LIANG Hui-ming
	YE Zhi-wei

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LIANG Hui-ming,YE Zhi-wei. Diagnosis and treatment in thoracolumbar spine and spinal cord injuries patients combined with thoracoabdominal injuries[J]. 中国当代医药, 2016, 23(12): 26-29.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I12/26

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