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急性颈脊髓损伤早期综合治疗的临床意义
Clinical of early synthetical treatment in patients with acute cervical spinal cord injury
【摘要】 目的评估急性颈脊髓损伤早期综合治疗的临床意义。方法48例急性颈脊髓损伤患者,其中完全性损伤23例,不完全性损伤25例,早期治疗方案:维持有效呼吸及循环血容量;应用大剂量甲基强的松龙(MP)及单唾液酸四己糖神经节苷脂钠(GM-I)等药物;行颅骨牵引术以制动和复位;早期行颈椎前路减压、植骨融合内固定术;术后尽早行高压氧治疗。结果随访43例,5例失访,死亡1例,随访时间18~24个月,神经功能获得改善者29例,其中完全性损伤者有效率为21.6%,不完全性损伤者有效率为78.3%,总有效率60.4%。结论急性颈脊髓损伤后早期综合治疗是抢救生命、保留和恢复残留脊髓神经功能较为有效的措施。
【Abstract】 [Objective] To evaluate the value of early synthetical treatment in patients with acute cervical spinal cord injury(SCI).[Method] 48 patients of acute SCI,including complete SCI in 23 patients and incomplete SCI in 25 patients,early synthetical treatment scheme was as follows:respiratory support and enough effective circulation volume,pharmacological treatment such as methyl prednisolone and GM-I,immobilization and reduction of the injured cervical spine by skull traction,early cervical decompression,reduction,graft and fixiation,early hyperbaric oxygen therapy after operation.[Result] Of the total 48 patients,one patient were dead and 5 patients were lost.A range of follow-up time was 18 to 24 months in 43 patients.The neurological recovery was detected in 29 patients.The neurological recovery rate was 21.6% in complete SCI,78.3% in incomplete SCI,60.4% in the total.[Conclusion] Initial synthetical treatment of acute cervical spinal cord injury can save life,significantly reserve and improve neurological in the patients with acute cervical spinal cord injury.
【Key words】 cervical spinal cord; acute injury; initial synthetical treatment;
- 【文献出处】 中国现代医学杂志 ,China Journal of Modern Medicine , 编辑部邮箱 ,2008年24期
- 【分类号】R651.2
- 【被引频次】2
- 【下载频次】125