儿童的创伤性脊柱损伤;是时候修改医院前和诊断协议了吗?
Michelle Oude Alink1, Huub Stassen1,2, Jochem Spoor2
1Department of Anesthesiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Journal of clinical medicine
|April 27, 2024
概括
儿童脊柱损伤很少发生,但严重. 这项研究确定了儿童的风险因素和诊断方法,并指出青少年的发病率较高,以及年幼儿童需要像MRI这样的先进成像技术.
科学领域:
- 儿科创伤学 儿科创伤学
- 脊髓损伤研究 脊髓损伤研究
- 儿科诊断成像 在儿科诊断成像.
背景情况:
- 儿童的创伤性脊柱损伤是一种罕见但严重的事件,带来了诊断挑战.
- 预测患有脊髓损伤风险的儿科患者需要了解损伤原因和预测因素.
- 这项研究旨在确定有风险的儿童和脊柱损伤的适当诊断程序.
研究的目的:
- 确定儿科创伤患者脊柱损伤的预测因素.
- 确定疑似儿科脊柱损伤的适当诊断程序.
- 分析不同儿科年龄组中脊柱损伤的发生率和特征.
主要方法:
- 对脊髓损伤的儿科患者进行了回顾性图表审查.
- 从2010年到2021年从Landelijke Trauma Registratie (国家创伤登记处) 收集的数据.
- 包括在一级儿科创伤中心治疗的患者.
主要成果:
- 包括114名脊髓损伤的儿童;79.8%的儿童年龄在12-17岁之间.
- 脊柱损伤发生率:在12-17岁儿童中为10%,在6-11岁儿童中为2.3%,在0-5岁儿童中为0.4%.
- 神经学缺陷存在于27.2%,其中14.0%是永久性的;脊柱骨折因年龄而异,在12-17岁的年龄段 (91.2%) 发生率更高.
结论:
- 脊柱损伤在0-11岁儿童中很罕见,通常涉及非骨损伤;建议在X射线后进行MRI.
- 在青少年 (12-17岁) 中,脊柱损伤的发生率更高 (10%);低的损伤严重性评分 (ISS) 不排除损伤.
- 一个脊柱骨折的存在需要进一步调查其他脊柱区域的额外骨折.
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