척추외상 환자의 치료에 대한 임상적 분석 -농촌 지역에서의 경험-
Clinical Analysis of Management of Spine-injured Patients -Experience in the Suburban-
소속 상세정보
김일만/Ill Man Kim
이시우/고삼규/지용철/이창영/Si Ou Lee/Sam Kuo Ko/Yong Chul Ji/Chang Young Lee
KMID : 0359819980270081059
Abstract
서론
최근 사회가 발전함에 따라 산업재해나 교통사고가 늘어남으로써 척추손상의 빈도가 증가
함은 잘 알려진 사실이다. 이러한 현상은 농촌지역에서도 농기계를 포함한 차량보급의 확대,
교통량의 증가 및 무질서한 교통질서 등의 이유도 예외가 아니다. 본 저자는 신경외과 초년
의로서 농촌지역에서의 외상성 척추 손상 환자의 빈도, 유형, 특징 및 치료상의 난점 등을
연구하여 향후 척추 손상 외상 환자 처치에 도움이 되고자 최근의 임상적 경험을 문헌 고찰
및 증례와 함께 보고하는 바이다.
#초록#
The incidence of spine trauma has been increasing. To investigate the incidence,
characteristics, and difficulty in management of the acute spine-injured patients in
suburban area we analyzed 50 cases treated conservatively or by operative fusion over a
recent one-year period.
This study comprised of 26 females and 24 males, between 23 and 83 years old
patients with injury of whole column of spine. The most frequent cause of injury was
traffic accident. The most common lesion was the compression fracture of the first
lumber spine. Most patients complained neck or back pain on admission. In 3 cases.
neurological deficits were noted. For six patients. surgical treatment were performed and
44 patients has been conservatively managed with halo brace. neck collars, and
thoracolumbar orthoses. The average period of admission and immobilzation for the
conservatively treated patients was 6 weeks. During which time a few complications
such as progressive kyphosis, hypoalbuminemia, thrombophlebitis, urinary tract infection,
paralytic ileus, bed sore, and alcohol withdrawal syndrome were aroused. In most cases,
good outcomes were achieved.
Most of geriatric patients, concomitant systemic disease with cardiovascular and
pulmonary dysfunction were usually present and absence of the insight on spine injury
made difficulties in management. On the basis of these results we concluded that most
elderly patients with spine fracture could be effectively treated by conservative methods,
and also careful and systemic management with adequate education for patients and
their families were required.
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