【摘要】 目的:探讨自体骨髓间质干细胞移植联合神经营养因子及综合康复治疗脊髓损伤的疗效和安全性。方法:经91例脊髓损伤患者知情同意并签署知情同意书后,给予自体骨髓间质干细胞移植联合神经营养因子及综合康复治疗。治疗前后按美国脊髓损伤学会评分标准评分,同时进行神经电生理和影像学方面的对比分析。治疗后每3个月随访1次,随访1年。结果:91例脊髓损伤患者术后美国脊髓损伤学会评分的平均数较术前提高,其中41例出现运动、感觉、影像学、神经电生理方面的不同改善;32例出现不同程度的运动、感觉、神经电生理方面的改善;12例出现神经电生理方面的改善;6例无变化。1例严重复合伤患者出现并发症,经积极治疗无效死亡。在随后的1年随访中,除2例失访外,其余患者均有不同程度进一步恢复的趋势,无明显不良反应发生。结论:自体骨髓间质干细胞移植联合神经营养因子及综合康复治疗可部分促进脊髓损伤的恢复,改善神经功能,是一种中西医结合治疗脊髓损伤安全有效的新策略,有临床推广应用价值。更多还原

【Abstract】 Objective To study the therapeutic effect and safty on spinal cord injury by autologous mesenchymal stem cells transplantation in combination with neurotrophic factors and comprehensive rehabilitation.Methods Totally 91 patients with spinal cord injury were enrolled and treated with autologous mesenchymal stem cells transplantation in combination with neurotrophic factors and comprehensive rehabilitation.All the patients knew the experiment and signed the informed consent.An evaluation was conducted before and after treatment according to American Spinal Injury Association scores.Simultaneously,controlled analysis was done in imageology and neural-electrophysiology.A follow-up survey was performed every three months after treatment,totally for 1 year.Results All of the 91 patients were smoothly discharged.The ASIA scores after treatment were higher than before treament.There were varying degrees of function,imageology and electrophysiology improvement in 41 patients.The function,sense and electrophysiology elevated in 32 patients.Electrophysiology was improved in 12 patients.Six patients showed no effect.One patient with serious compound wound died of complication.In the one-year follow-up,2 patients were dropped out,and the other was improved,and no obvious adverse reactions were found.Conclusion Autologous mesenchymal stem cells transplantation in combination with neurotrophic factors and comprehensive rehabilitation may partially promote the restoration of injured spinal cord and improve neurological functions.It is a new,effective and safe strategy,which integrates traditional and western medicine for treatment of spinal cord injury and is worthy to apply in clinic.更多还原