【摘要】 目的比较下颈椎外伤导致颈脊髓损伤患者早期手术(伤后<8h)与延期手术(伤后>8h)的临床效果,及服用中药的疗效及安全性。方法自2012年1月～2016年12月,对我院接诊的下颈椎外伤导致颈脊髓损伤并行手术治疗患者的临床资料进行回顾性分析,根据受伤到手术时间间隔以及中药使用情况将患者分为3组:A组(<8h)、B组(<8h+中药)、C组(>8h)、D组(>8h+中药)。通过比较4组患者手术前后神经恢复情况,并统计分析损伤严重程度等基本资料,明确早期手术的意义及中药对脊髓损伤的治疗价值。结果 72例患者中21例患者神经恢复达到2级。术后神经功能改善达1级者,4组间差异无统计学意义;改善达2级者,A组与C组、B组与D组组间相比,差异均有统计学意义。A组+B组与C组+D组相比,差异也有统计学意义。但A组与B组之间,C组与D组之间相比,差异均无统计学意义。B组1例患者术后出现椎动脉栓塞、脑梗死。结论外伤导致的颈脊髓损伤无明确手术禁忌时,建议早期手术,中药可能对改善手术预后有帮助,其有效性需要进一步观察;对颈椎外伤患者要注意椎动脉损伤相关并发症。更多还原

【Abstract】 Objective To compare the neurological outcome between the early surgery group(<8 h) and delayed surgery group(>8 h),and observe safety, curative effect of Chinese herbs.Methods From January 2012 to December 2016,72 lower cervical vertebrae injury patients were operated.According to the number of hours lapsed between the trauma and operation, Chinese herbs used or not, the patients were divided into four groups: Group A(<8 h),Group B(<8 h and take Chinese herbs),Group C(>8 h),Group D(>8 h and take Chinese herbs).The neurological outcomes and other basic data of patients for accessing curative effect of early surgery were compared in order to conform the usefulness and safety of Chinese herbs in treating acute spinal cord injury.Results For all the 72 patients, 21 patients recovered 2 grades.No significant differences were noted either between Group A and Group B or between Group C and Group D.There was significant difference not only between Group A and Group C,but also between Group B and Group D.Neurology result of Group A+Group B was significantly better than Group C+Group D.One patient of Group B had pontine necrosis because of vertebral artery embolism.Conclusions If there is no contraindication of surgery, we suggest surgery as early as possible.Maybe Chinese herbs is helpful for neurological recovery, but further observation is needed.For cervical spinal cord injury, notation should be paid to complications, such as vertebral artery injury.更多还原