南京医科大学学报（自然科学版）2025，Vol.45Issue(3)：346-352,359,8.DOI:10.7655/NYDXBNSN241372
基于急诊CT的创伤性颈髓损伤危险因素研究
Research on risk factors of traumatic cervical spinal cord injury based on emergency CT
摘要
Abstract
Objective:To evaluate the risk factors and prognostic impact of traumatic brain injury(TBI)combined with traumatic cervical spinal cord injury(TCSCI)in patients with multiple traumas based on emergency CT.Methods:A retrospective analysis was conducted on the data of 218 patients with multiple traumas who were admitted to the emergency department of the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022,in whom TCSCI was not excluded.Patients were divided into the TCSCI group and non-TCSCI group based on cervical MRI results.Multivariate logistic regression analysis was used to screen for independent risk factors,construct a receiver operating characteristic(ROC)curve prediction model,and perform internal validation.Results:TCSCI was identified in 69 patitents(31.7%).Multivariate logistic regression analysis showed that higher head abbreviated injury scale(hAIS)scores(OR=1.552,95%CI:1.101-2.188),sub-axial injury classification(SLIC)scores(OR=1.235,95%CI:1.006-1.517),and paraplegia symptoms(OR=3.810,95%CI:1.115-13.020)were independent risk factors for TCSCI.The ROC curve for the predictive model showed an area under the curve(AUC)of 0.900(95%CI:0.859-0.941).The Hosmer-Lemeshow test confirmed good discriminative ability and calibration of the model.Conclusion:hAIS,SLIC scores,and paraplegia symptoms are independent risk factors for TCSCI in patients with multiple traumas.Emergency CT combined with assessment of hAIS,SLIC scores,and paraplegia may effectively identify high-risk TCSCI patients with multiple traumas where TCSCI cannot be excluded.关键词
创伤性颈髓损伤/急诊CT/头部简明损伤评分/下颈椎损伤分类/截瘫症状/危险因素Key words
traumatic cervical spinal cord injury/emergency CT/head abbreviated injury scale score/sub-axial injury classifica-tion/paraplegia symptom/risk factors分类
临床医学引用本文复制引用
周正,方熙,康健,李华,陈旭锋,周浩,李琳..基于急诊CT的创伤性颈髓损伤危险因素研究[J].南京医科大学学报（自然科学版）,2025,45(3):346-352,359,8.基金项目
国家自然科学基金(82302794) （82302794）
江苏省基础研究计划自然科学基金(BK20220734) （BK20220734）
江苏省人民医院临床能力提升工程项目(JSPH-MC-2022-28) （JSPH-MC-2022-28）
