楊 帆(Yang Fan，Dept Traumat Surg，Affil Tongji Hosp，Tongji Med Col，Huazhong Univ Sci Technol，Wuhan 430030)…∥Chin J Trauma.－2011，27(2).－152～156

Clinical features of multiple trauma patients combined with spine and spinal cord injuries

楊 帆(Yang Fan，Dept Traumat Surg，Affil Tongji Hosp，Tongji Med Col，Huazhong Univ Sci Technol，Wuhan 430030)…∥Chin J Trauma.－2011，27(2).－152～156

ObjectiveTo analyze the clinical features of the multiple trauma patients combined with spine and spinal cord injuries.MethodsA retrospective study was performed in 143 multiple trauma patients combined with spine and spinal cord injuries admitted to our department between March 2004 and March 2009.The parameters including injury cause，segment of injuries，associated injuries，complications，treatment methods and outcomes were analyzed.ResultsFalling and traffic accidents were the main causes for the injuries of spine and spinal cord，accounting for 53.8% (77 cases)and 38.5% (55 casees)，respectively.The injured segments involved 101 lumbar vertebrae(4.0%).The associated injuries were located at chest(163 regions，38.6%)，abdomen(84 regions，19.9%)，head and neck(77 regions，18.3%)，extremity(65 regions，15.4%)，face(17 regions，4.0%)and body surface(16 regions，3.8%).The early complications included electrolyte disturbances in 33 patients(16.8%)，respiratory infection in 30(15.3%)and abdominal distention in 19(9.7%).The late complications were malnutrition in 26 patients(13.3%)，amyotrophy in 23(11.7%)and deep vein thrombus in 11(5.6%).Treatment methods were operations and expectant treatments in 106 patients(74.%)and 37(25.9%)respectively.According to Americal Spinal Injury Association(ASIA)scale，there were 20 patients(14.0%)at grade E before treatment and 53(37.1%)at grade E after treatment.Of all，12 patients died of mainly multiple organ failure(MOF)，cerebral hernia and malnutrition，with mortality rate of 8.39%.There showed an increase of complication and mortality rate with increase of ASIA grade(P ＜0.05).ConclusionThe spine and spinal cord injuries in patients with multiple trauma are mainly caused by high energy injuries and characterized by high injury severity，complex associated injuries，multiple complications，diffcult management and high mortality rate.22 refs，4 tabs.

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