摘要
脊柱骨折合并上升性截瘫是一个值得临床重视的事实。本文报告上升性截瘫12例,占同期全部脊柱骨折截瘫病例的2.2%。本组病例的特点是:原发损伤严重,受伤部位通常在脊柱胸腰段,截瘫平面开始上升时间多数在伤后第三天,上升进展到2～3周后停止,上升平面3～9个节段,平均6个节段,截瘫平面上升后不再下降,并长期表现为弛缓性截瘫。12例中近期死亡4例,原因有截瘫平面上升引起的呼吸衰竭、全身衰竭和褥疮。本文根据临床观察并结合有关文献复习,讨论脊柱骨折脱位合并上升性截瘫发生的原因,认为与脊髓的血液供应障碍有关;可能是由于最大根动脉和脊髓动脉血流中断或血栓形成导致胸腰段脊柱骨折脱位合并上升性截瘫。
Ascending paralysis complicating fracture-dislocation of spine deserves special attention. Five hundred and fifty-one cases of fracture-dislocatlon of spine with paraplegia were admitted in this hospital from 1971 through 1988. Twelve cases with ascending paralysis, 2.2% of all spine fracture patients admitted during the same period, were presented. It usually occurred at the thoracolumbar region following asevere trauma. The level of paralysis usually began to go up on the third day after injury. It took 2～3 weeks to asccend 3～9 segments (with an average of 6 segments) above the level of cord injury and than remained stationary, It appeared in the form of flaccid paralysis.
Four patients died of respiratory failure early in the course of the trauma as a direct result of ascending paralysis, general exhaustion and bed sores. The disruption or thrombosis of the radicular and spinal arteries were the main pathologic feature found.
出处
《创伤杂志》
CAS
CSCD
北大核心
1989年第2期71-73,共3页
