中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
3期
213-216
,共4页
脊髓%损伤%气管切开术%影响因素
脊髓%損傷%氣管切開術%影響因素
척수%손상%기관절개술%영향인소
Spinal cord%Injury%Tracheotomy%Influencing factors
目的 分析颈脊髓外伤后气管切开指征的影响因素. 方法 回顾性研究2004年7月至2014年6月收治的颈椎以外的部位简明损伤评分小于3分的118例颈椎骨折脱位伴有脊髓损伤患者资料,男96例,女22例;年龄19 ～68岁,平均45.2岁.将患者根据气管是否切开分为切开组(28例)和未切开组(90例),比较两组患者的性别、年龄、入院时是否完全脊髓损伤、颈椎损伤节段、受伤机制、是否吸烟、入院时创伤严重度评分(ISS)、美国脊髓损伤协会(ASIA)运动评分、收缩压、住院时间、ICU住院时间,并采用logistic回归分析气管切开的影响因素. 结果 与气管未切开组比较,气管切开组的完全脊髓损伤比率更高、吸烟率更高、入院时ISS评分更高、入院时AISA运动评分更低、住院时间和ICU住院时间更长,差异均有统计学意义(P＜0.05),而两组患者的性别、年龄、颈椎损伤节段、受伤机制及入院时收缩压比较差异均无统计学意义(P＞0.05).气管切开影响因素为完全脊髓损伤、吸烟、ISS评分、ASIA运动评分. 结论 完全性脊髓损伤、吸烟、ISS、ASIA运动评分为颈脊髓损伤后气管切开的影响因素.
目的 分析頸脊髓外傷後氣管切開指徵的影響因素. 方法 迴顧性研究2004年7月至2014年6月收治的頸椎以外的部位簡明損傷評分小于3分的118例頸椎骨摺脫位伴有脊髓損傷患者資料,男96例,女22例;年齡19 ～68歲,平均45.2歲.將患者根據氣管是否切開分為切開組(28例)和未切開組(90例),比較兩組患者的性彆、年齡、入院時是否完全脊髓損傷、頸椎損傷節段、受傷機製、是否吸煙、入院時創傷嚴重度評分(ISS)、美國脊髓損傷協會(ASIA)運動評分、收縮壓、住院時間、ICU住院時間,併採用logistic迴歸分析氣管切開的影響因素. 結果 與氣管未切開組比較,氣管切開組的完全脊髓損傷比率更高、吸煙率更高、入院時ISS評分更高、入院時AISA運動評分更低、住院時間和ICU住院時間更長,差異均有統計學意義(P＜0.05),而兩組患者的性彆、年齡、頸椎損傷節段、受傷機製及入院時收縮壓比較差異均無統計學意義(P＞0.05).氣管切開影響因素為完全脊髓損傷、吸煙、ISS評分、ASIA運動評分. 結論 完全性脊髓損傷、吸煙、ISS、ASIA運動評分為頸脊髓損傷後氣管切開的影響因素.
목적 분석경척수외상후기관절개지정적영향인소. 방법 회고성연구2004년7월지2014년6월수치적경추이외적부위간명손상평분소우3분적118례경추골절탈위반유척수손상환자자료,남96례,녀22례;년령19 ～68세,평균45.2세.장환자근거기관시부절개분위절개조(28례)화미절개조(90례),비교량조환자적성별、년령、입원시시부완전척수손상、경추손상절단、수상궤제、시부흡연、입원시창상엄중도평분(ISS)、미국척수손상협회(ASIA)운동평분、수축압、주원시간、ICU주원시간,병채용logistic회귀분석기관절개적영향인소. 결과 여기관미절개조비교,기관절개조적완전척수손상비솔경고、흡연솔경고、입원시ISS평분경고、입원시AISA운동평분경저、주원시간화ICU주원시간경장,차이균유통계학의의(P＜0.05),이량조환자적성별、년령、경추손상절단、수상궤제급입원시수축압비교차이균무통계학의의(P＞0.05).기관절개영향인소위완전척수손상、흡연、ISS평분、ASIA운동평분. 결론 완전성척수손상、흡연、ISS、ASIA운동평분위경척수손상후기관절개적영향인소.
Objective To determine the factors influencing the indication for tracheostomy following cervical spinal cord injury.Methods A retrospective study was performed to analyze the 118 patients who had been treated for cervical fracture/dislocation along with cervical spinal cord injury from July 2004 to June 2014 and whose abbreviated injury scale score (AISS) was lower than 3.They were 96 men and 22 women,19 to 68 years of age (average,45.2 years).The patients were divided into a tracheostomy group (n ＝ 28) and a non-tracheostomy group (n =90).The 2 groups were compared in terms of gender,age,presence or absence of complete spinal cord injury at admission,injured segment,injury mechanism,smoking history,injury severity score (ISS),motor AISS,systolic pressure at admission,hospital stay,and ICU stay to determine the factors influencing allocation of tracheostomy.Results Compared with the non-tracheostomy group,the tracheostomy group had a higher rate of complete spinal cord injury at admission,a higher rate of smoking,a higher ISS at admission,a lower motor AISS,and longer hospital and ICU stay,with statistically significant differences (P ＜ 0.05).There were no significant differences between the 2 groups in gender,age,injured segment,injury mechanism,or systolic pressure at admission (P ＞ 0.05).Increased severity of cervical spinal cord injury was associated with significantly decreased motor AISA,increased rate of tracheostomy and increased ISS (P ＜ 0.05).Conclusion The influencing factors for indication of tracheostomy after cervical spinal cord injury are complete cervical spinal cord injury irrespective of the level of injury,ISS,motor AISS,and history of smoking.
