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目的了解多发伤中颅脑损伤、颈椎损伤与胸部损伤相互之间的联系。方法收集武汉同济医院创伤外科病房2005年1月～2009年12月收治的存在颅脑损伤、颈椎损伤和(或)胸部损伤的2 667例多发伤患者的临床资料进行回顾性研究,分析三者之间的联系。结果颅脑损伤合并颈椎损伤的发生率为8.77%,合并胸部损伤的发生率为35.77%,同时合并颈椎和胸部损伤的发生率为4.83%。颈椎损伤合并颅脑损伤的发生率为57.71%,合并胸部损伤的发生率为86.11%,同时合并颅脑和胸部损伤的发生率为31.79%。胸部损伤合并颅脑损伤的发生率为57.54%,合并颈椎损伤的发生率为21.04%,同时合并颅脑和颈椎损伤的发生率为7.77%。2 667例中有473例发生漏诊,占17.74%。结论多发伤中颅脑、颈椎、胸部损伤之间关联密切,确诊有1处损伤时,应考虑是否合并其他2处部位损伤。提高对三者联系的认识,制定合理的临床诊疗流程,有助于减少漏诊和提高创伤救治效果。
Objective To understand the relationship between traumatic brain injury, cervical injury and chest injury in multiple trauma. Methods A retrospective study was conducted on the clinical data of 2 667 cases of multiple trauma patients with traumatic brain injury, cervical spine injury and / or chest injury admitted from January 2005 to December 2009 in the traumatic surgery ward of Tongji Hospital in Wuhan. the relationship between. Results The incidence of traumatic brain injury combined with cervical injury was 8.77%. The incidence of complicated chest injuries was 35.77%. The incidence of cervical and thoracic injuries was 4.83%. The incidence of cervical injury combined with craniocerebral injury was 57.71%. The incidence of combined thoracic injury was 86.11%. The incidence of craniocerebral and thoracic injuries was 31.79%. The incidence rate of chest injury combined with craniocerebral injury was 57.54%. The incidence of combined cervical injury was 21.04%. The incidence of combined craniocerebral and cervical injuries was 7.77%. Of the 2 667 cases, 473 missed diagnosis, accounting for 17.74%. Conclusions Multiple injuries in the brain, cervical, chest injury is closely related to the diagnosis of a injury, should consider whether the merger of the other two parts of the injury. Improve the understanding of the three links, to develop a reasonable clinical diagnosis and treatment process, help to reduce missed diagnosis and improve the effectiveness of trauma.