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纵向压缩暴力作用于人体,往往引起颈椎和腰椎的损伤,但受病理因素和受伤当时体位的影响,也可累及其他椎体,笔者在临床检案中遇C_7T_1椎体损伤致死一例,介绍如下:案情摘录:某男,41岁,医生,某日在汽车站与站台人员发生纠纷,被人从客车车门处推下客车,左臀部着地,当即感颈部疼痛,双下肢不能活动,一小时后送医院治疗。查体:生命体征正常,神清,精神差,双瞳孔等大等圆,直径3mm,光反射存在,右上肢肌为正常,左上肢肌力3级,双上肢感觉存在胸一椎体平面以下躯干部肌为0级,运动消失,各浅反射减弱,深反射消失,二便失禁,C_6-T_2压痛明显,辅检:C_7椎体楔状压缩骨折,治疗期间脊髓损伤逐渐加重,5日后行颅骨牵引术,6日后突然神志不清,呼吸停止,经人工呼吸机维持,后逐渐出现循环衰竭,10日后心跳停止,经抢救无效死亡。
Longitudinal compression of violence on the human body, often caused by cervical and lumbar injury, but by the pathological factors and the impact of body position at the time of injury may also affect other vertebral body, the author in case of clinical case of C_7T_1 vertebral injury in one case, described as follows: Excerpt from the case: A male, 41 years old, a doctor, one day in the bus station and platform personnel disputes, was pushed from the passenger car at the bus, left hip to the ground, immediately felt neck pain, both lower extremities can not move, one hour later To the hospital for treatment. Physical examination: vital signs normal, clear spirit, poor spirit, double pupil and other large circle, diameter 3mm, light reflex exists, right upper limb muscle is normal, left upper limb muscle strength 3, upper extremity feel chest below a vertebral plane The trunk muscle was grade 0, the motion disappeared, the shallow reflex decreased, the deep reflex disappeared, the second incontinence, C_6-T_2 tenderness was obvious. The auxiliary check: C_7 vertebral wedge compression fractures, spinal cord injury gradually increased during treatment, Traction, sudden unconsciousness after 6 days, breathing stopped, maintained by the respirator, and then gradually appear circulatory failure, 10 days after the heartbeat stopped, the rescue died.