【摘要】 目的分析创伤性颈髓损伤后急性期血钙、心率、血压之间的相关性,为临床工作提供数据支持。方法回顾性分析2010年1月至2014年12月我院收治的12 h内创伤性颈髓损伤患者65例,患者神经功能根据美国脊髓损伤协会(ASIA)损伤系统分级法,颈脊髓损伤的严重性(Frankel分级),随机分为两组,将Frankel A/B级归为完全性颈髓损伤者35例(A组),男20例,女15例,年龄15~65岁,平均(38.4±3.2)岁,将Frankel C/D归为不完全性颈髓损伤者30例(B组),男18例,女12例,年龄20~63岁,平均(37.6±2.8)岁。均于入院后即刻、第3、7、14天抽取静脉血测血钙,取其平均值;入院后2周内,持续心电监护,每2 h测血压、心率1次,取即刻、第3、7、14天的平均值作为统计参数;并对以上因素组间、组内数据运用总体均数估计、卡方检验、直线相关性来进行统计学分析。结果资料收集无缺失;A、B两组间一般资料包括年龄、性别、来院时间、损伤水平、椎管狭窄节段比较差异均无统计学意义(P>0.05);完全性颈髓损伤患者全部出现低血钙,损伤出现严重并且持续时间长;不完全性颈髓损伤中20例(66.7%)出现低血钙。A、B两组组间即刻、第3、7、14天血钙、心率、收缩压比较差异有统计学意义(P<0.05);两组相关性分析显示,A组血钙、心率、收缩压之间存在明显相关性(r>0.5,P<0.01),B组无相关性(r<0.5,P>0.05)。结论创伤性颈髓损伤后急性期患者血钙、心率、血压存在变化,血钙水平、心率、血压在完全性颈脊髓损伤组相关性更明显且呈正相关,脊髓损伤越严重相关性越强。更多还原

【Abstract】 Objective To analyze the relation between the blood calcium, heart rate and the blood pressure in early stage(2 weeks) after acute traumatic cervical spinal cord injury(SCI), provide data support for clinical work. Methods A retrospective review of 65 cases with acute cervical spinal cord injury between Jan. 2010 and Dec. 2014 was undertaken. Of these patients, all cases were admitted to our hospital in 12 hours injury. The neurologic clinical status of patients was assessed according to the American Spinal Injury Association(ASIA) impairment scale. Severe complete SCI(Frankel grades A/B) was determined in 35 patients of these patients(A group), incomplete tetraplegia(Frankel grades C/D) was determined in 30 patients of these patients(B group); There were 35 complete SCI(15 women, 20 men; ages 15-65 years; mean, 38.4±3.2) and 30 patients in the incomplete tetraplegia(12 women, 18 men; ages 20-63 years; mean 36.6±2.8). Within two weeks of hospitalization, persist warding the electrocardiogram, the blood pressure and heart rate were monitored every two hours; 35 patients had complete quadriplegia and 30 patients had incomplete quadriplegia. The concentration of blood calcium, blood pressure and heart rate of each patients were tested immediately, in the early morning of 3rd days, 7th and 14 th days after injury, the relationship between blood pressure and heart rate degree of blood calcium and the level as well as degree of cervical spinal cord injury were analyzed statistically by the overall average number of estimates, χ2 test, linear correlation. Results Group between immediate data collection without missing; A or B groups general information including age, gender, hospital time, level of injury, spinal canal stenosis segment were compared(P>0.05); complete cervical spinal cord injury were all low blood calcium, injury serious and sustained for a long time; not complete cervical spinal cord injury in 20 cases(66.7%) had low blood calcium. A, B two groups, immediately, 3 days, 7 days, 14 days, serum calcium, heart rate and systolic blood pressure were compared(P<0.05), suggested that the difference was statistically significant; correlation analysis of two groups, A correlation analysis of r>0.5 and P<0.01, suggesting that calcium, rhythm of the heart, systolic blood pressure had significant correlation; the B group, r<0.5 and P>0.05, suggested that the correlation was not statistically significant. Conclusions Hypocalcemia, hypotension and bradycardia is common in the early stage post-SCI, the occurrence of hypocalcemia secondary to cervical spinal cord injury is related to blood pressure and heart rate injury extent, and the lower blood calcium, the higher mortality and morbidity.更多还原