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目的总结对颅脑损伤合并颈椎损伤病人的诊治经验。方法回顾性分析46例颅脑损伤合并颈椎损伤病人的临床资料。结果术后生存42例,死亡4例。颈椎损伤病人早期漏诊5例,因未及时行颈椎X-线平片或CT检查,致死亡1例,截瘫1例。颅骨牵引继发硬膜外血肿或原血肿加大者4例,新增血肿多在颅骨骨折处,而颅骨骨折多因入院未行CT骨窗扫描漏诊或被忽略,致死亡1例。吸取上述经验后,对5例颅颈复合伤病人一经确诊即与骨科同台早期手术。结论对颅颈复合伤病人,早期行颈椎CT、X-线平片检查及头颅CT骨窗扫描可减少颈椎损伤及颅骨骨折漏诊率。早期脑外科与骨科同台手术,可减少并发症。
Objective To summarize the diagnosis and treatment of patients with craniocerebral injury and cervical injury. Methods The clinical data of 46 patients with traumatic brain injury and cervical injury were retrospectively analyzed. Results Postoperative survival in 42 cases, 4 deaths. In the early stage of cervical spine injury, 5 cases were missed due to early misdiagnosis. One case of death and one case of paraplegia were diagnosed as not having undergone cervical X-ray plain film or CT examination in time. There were 4 cases of extradural hematoma or hematoma secondary to skull traction, and more new hematomas were found in the skull fractures. However, skull fractures were mostly missed or overlooked due to the lack of CT scan in the hospital, which resulted in 1 death. After learning the above experience, 5 cases of craniocerebral injury patients were diagnosed with orthopedic on the same stage of early surgery. Conclusion For patients with craniocervical combined injury, cervical spine CT, X-ray plain film and cranial CT scan can reduce the rate of misdiagnosis of cervical injury and skull fracture. Early brain surgery and orthopedic surgery, can reduce complications.