【摘要】 目的比较非手术治疗与早期外科干预在治疗成人颈段无骨折脱位型脊髓损伤中的作用。方法回顾性分析了自2009-03—2012-10治疗并获得随访的47例成人颈段无骨折脱位型脊髓损伤的临床资料,其中21例行激素脱水及营养神经等非手术治疗,26例于伤后72 h内行手术治疗,通过美国脊髓损伤协会(ASIA)神经功能评定标准评估临床疗效,观察各组治疗前后及随访各时间点的ASIA运动评分以及相关并发症。结果非手术及手术治疗均能有效改善患者损伤脊髓的神经功能,早期手术干预组术后临床疗效明显优于非手术治疗组,ASIA运动评分差异有统计学意义(P<0.05),非手术治疗与早期手术组肺部感染的发生率分别为9.5%、3.8%,两者差异有统计学意义(P<0.05)。结论急性成人颈段无骨折脱位型脊髓损伤早期外科干预疗效明显优于非手术治疗,非手术治疗并发症相对较多。更多还原

【Abstract】 Objective To compare retrospectively the functional recovery of adult patients with cervical spinal cord injury without bone injury and dislocation(SCIWo BID) by conservative and early surgical treatments(<72 h after injury). Methods A retrospective analysis was performed for 47 patients with SCIWo BID treated from 2009 March through 2012 October and followed up. Twenty one patients underwent conservative treatments and 26 were treated with early surgical intervention. The neurological assessments with ASIA(American Spinal Injury Association) motor scores for all patients before and after operation were conducted, as well as evaluation of complications post-treatments. Results Early surgical therapy significantly improved the neurological outcome compared to the conservative treatment. The ASIA motor scores were statistically different after clinical treatments and between the two groups at individual timing points after treatment( P <0.05). In addition, the incidence of pneumonia in the conservative group was higher than early surgery group with significantly statistical difference(P <0.05). Conclusion Surgical treatments produce the better clinical outcome for the adult patients with SCIWo BID than conservative therapies not only with neurological assessments but also in the pulmonary complications occurred after treatments.更多还原