摘要
目的：评价早期脊髓复苏在急性颈脊髓损伤治疗中的意义。方法：106例急性颈脊髓损伤患者，其中脊髓完全性损伤21例，脊髓不完全性损伤85例。早期脊髓复苏方案包括：(1)维持呼吸道通畅和足够有效的血容量，维持平均动脉血压100mmHg以上，血氧饱和度在95％以上；(2)应用大剂量甲基强的松龙或地塞米松等药物治疗；(3)行颅骨牵引制动或复位颈椎；(4)早期进行颈椎减压植骨融合内固定术；(5)术后早期应用高压氧治疗。结果：死亡7例，失访5例，94例获得12～52个月的随访。随访病例中69例患者神经功能获得改善。其中完全性损伤组有效率为23．3％，不完全性损伤组有效率为74．1％，总有效率为65．1％。结论：颈脊髓损伤后早期复苏治疗是保留和恢复残留脊髓神经功能较为有效的措施。
Objective：To evaluate the value of early resuscitation treatment in patients with acute cervical spinal cord injury（SCI）Method：106 patients of acute SCI,including complete SCI in 21 patients and incomplete SCI in 85 patients,were analyzed.Resuscitation scheme was as follows： （1）Respiratory support and enough effective circulation volume for the maintenance of arterial blood pressure to more than 100mmHg and oxygen saturation to more than 95%.（2）Pharmacological treatment such as methylprednisolone and dexametha sone.（3）Immobilization and reduction of the injured cervical spine by skull traction.（4）Eearly cervical decom pression,reduction,graft and fixiation. （5）Early hyperbaric oxygen therapy after operation.Result：Of the total 106 patients,7 patients were dead and 5 patients were lost.A range of follow-up time was 12 to 52 months in 94 patients.The neurological recovery was detected in 69 patients.The neurological recovery rate was 23.8% in complete SCI,74.1% in incomplete SCI,65.1% in the total.Conclusion： Initial resuscitation treatment of acute cervical spinal cord injury can significantly reserve and improve neurological function in the patients with acute cervical SCI.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2005年第12期709-712,共4页
Chinese Journal of Spine and Spinal Cord
关键词
脊髓损伤
脊髓复苏
早期处理
Spinal cord injury
Resuscitation of spinal cord
Initial treatment
