摘要
目的分析高原地区急性颈髓损伤(ACSCI)早期并发症的种类及特点,以及致早期并发症的危险因素,为完善和改进早期救治方案及措施提供参考。方法回顾性分析青海省人民医院骨科2001年1月-2015年12月收治的ACSCI患者120例的临床资料。分析早期各种并发症的发生分布情况,并根据患者是否出现并发症将ACSCI患者分为并发症组(n=90)和无并发症组(n=30),通过单因素和多因素Logistic回归分析ACSCI患者出现早期并发症的危险因素。结果高原地区急性颈髓损伤出现早期并发症与年龄≥45岁、合并颅脑损伤、ACSCI完全损伤、颈髓损伤节段C5~7、使用糖皮质激素以及气管切开呈正相关,与本市定居时间<1年呈现负相关(P<0.05);与血清白蛋白水平、血淋巴细胞比例无相关性(P>0.05)。多因素Logistic回归分析显示,年龄≥45岁、本市定居时间<1年、颈髓损伤节段C5~7、合并颅脑损伤、气管切开及ACSCI完全损伤是高原地区ACSCI出现早期并发症的危险因素(OR/P=1.791/0.028、1.262/0.040、2.254/0.016、5.543/0.008、3.845/0.016、2.992/0.031)。结论高原地区急性颈髓损伤出现早期并发症的危险因素为年龄≥45岁、本市定居时间<1年、颈髓损伤节段C5~C7、合并颅脑损伤、气管切开及ACSCI完全损伤,损伤早期应对上述可控高危因素进行综合防治,降低早期并发症发生率。
Objective To analyze the types and characteristics of early complications of acute cervical spinal cord injury(ACSCI)at high altitude,and the risk factors of early complications,so as to provide reference for improving the early treatment plan and measures.Methods The clinical data of 120 patients with ACSCI admitted to Orthopaedics Department of Qinghai People’s Hospital from January 2001 to December 2015 were retrospectively analyzed.The distribution of early complications was analyzed,and ACSCI patients were divided into complications group(n=90)and non-complications group(n=30)according to whether there were complications.The risk factors of early complications in ACSCI patients were analyzed by univariate and multivariate logistic regression.Results The early complications of acute cervical spinal cord injury in the high altitude area were positively correlated with age≥45 years,combined craniocerebral injury and ACSCI complete injury,cervical spinal cord injury segment C5-C7,glucocorticoid use and tracheotomy,and negatively correlated with city settlement time<1 year(P<0.05).There was no correlation with serum albumin level and blood lymphocyte ratio(P>0.05).Multivariate logistic regression analysis showed that the age was≥45 years old,the city’s settlement time was<1 year,and the cervical spinal cord injury segment was C5~7.Combined brain injury,tracheotomy,and complete ACSCI injury were risk factors for early complications of ACSCI in the high altitude area(OR/P=1.791/0.028,OR/P=1.262/0.040,OR/P=2.254/0.016,OR/P=5.543/0.008,OR/P=3.845/0.016,OR/P=2.992/0.031).Conclusion The risk factors of early complications of acute cervical spinal cord injury in plateau area are age(>45 years old),settlement time(<1 year),C5-C7 of cervical spinal cord injury segment,combined craniocerebral injury,tracheotomy and ACSCI complete injury.Comprehensive prevention and treatment of these controllable high-risk factors should be carried out in early stage of injury to reduce the incidence of early complications.
作者
张富财
郑峰
王福荣
李沛
ZHANG Fucai;ZHENG Feng;WANG Furong;LI Pei(Department of Orthopedics,Qinghai People's Hospital,Xining 810000,China)
出处
《疑难病杂志》
CAS
2019年第7期696-700,704,共6页
Chinese Journal of Difficult and Complicated Cases
基金
青海省卫计委医药卫生科研指导性计划课题(2016-wjzdx-06)
关键词
高原地区
颈髓损伤
急性
早期并发症
危险因素
Plateau region
Acute
Cervical spinal cord injury
Early stage complications
Risk factors
