脊柱骨折脱位合并脊髓损伤的早期治疗
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摘要
目的研究脊柱骨折脱位合并脊髓损伤的早期治疗方法及治疗效果。方法选取2015年1月—2016年12月期间该院收治的72例脊柱骨折脱位合并脊髓损伤的患者作为研究对象,采用美国脊柱损伤协会(ASIA)神经功能分级标准,评价患者脊柱损伤程度,其中12例为A级,22例为B级,15例为C级,其余23例为D级,所有患者早期均予以针对性治疗,比较治疗效果。结果该次研究中72例患者均进行了为期12~18个月的随访,平均随访时间为(13.76±1.49)个月,再次采用ASIA神经功能分级标准,评价患者神经功能恢复情况,其中以恢复至E级(感觉和运动功能正常)为优,该次研究中有42例符合E级标准,占58.33%,以A、B、C级升高至D级为良,该次研究中有18例符合良标准,占25.00%,以神经功能升高1级为可,该次研究中有8例符合可标准,占11.11%,其余4例不符合上述标准为无效,占5.56%,统计可知,患者的神经功能恢复优良率达到了83.33%。结论脊柱骨折脱位合并脊髓损伤的患者早期应予以脊髓减压术治疗,并结合应用大剂量激素,尽早实施手术治疗,以促进患者感觉及运动功能的恢复。
Objective To research the early treatment method and effect of spinal fracture dislocation and spinal injury.Methods 72 cases of patients with spinal fracture dislocation and spinal injury admitted and treated in our hospital from January 2015 to December 2016 were selected as the research objects and the spinal injury degree of patients was evaluated by the nerve function classification standards of ASIA, including 12 cases in A level, 22 cases in B level, 15 cases in C level and the other 23 cases in D level, and all patients adopted the early targeted treatment, and the treatment effect was compared. Results All the 72 cases in this study were followed up for 12 to 18 months,(13.76±1.49) months on average, and the nerve function recovery was evaluated by the ASIA nerve function classification standards, and the excellent was to return to E level(normal sensory function and motion function), and in the study, 42 cases met the E level standard, accounting for 58.33%, and the good was increasing from A, B, C levels to D level, and 18 cases in this study met the good standard, accounting for 25.00%, the fair was that the nerve function increased by 1 level, and 8 cases in the study met the standard, accounting for 11.11%, and the other 4 cases didn't meet the above standards, accounting for 5.56%, and the statistics showed that the excellent and good rate of recovery of nerve function recovery reached 83.33%. Conclusion The decompression of spinal cord and application of large-dose hormone should be used in treatment of patients spinal fracture dislocation and spinal injury during the early stage, and the operation treatment should be performed as early as possible to promote the recovery of sensory and motion functions.
Objective To research the early treatment method and effect of spinal fracture dislocation and spinal injury.Methods 72 cases of patients with spinal fracture dislocation and spinal injury admitted and treated in our hospital from January 2015 to December 2016 were selected as the research objects and the spinal injury degree of patients was evaluated by the nerve function classification standards of ASIA, including 12 cases in A level, 22 cases in B level, 15 cases in C level and the other 23 cases in D level, and all patients adopted the early targeted treatment, and the treatment effect was compared. Results All the 72 cases in this study were followed up for 12 to 18 months,(13.76±1.49) months on average, and the nerve function recovery was evaluated by the ASIA nerve function classification standards, and the excellent was to return to E level(normal sensory function and motion function), and in the study, 42 cases met the E level standard, accounting for 58.33%, and the good was increasing from A, B, C levels to D level, and 18 cases in this study met the good standard, accounting for 25.00%, the fair was that the nerve function increased by 1 level, and 8 cases in the study met the standard, accounting for 11.11%, and the other 4 cases didn't meet the above standards, accounting for 5.56%, and the statistics showed that the excellent and good rate of recovery of nerve function recovery reached 83.33%. Conclusion The decompression of spinal cord and application of large-dose hormone should be used in treatment of patients spinal fracture dislocation and spinal injury during the early stage, and the operation treatment should be performed as early as possible to promote the recovery of sensory and motion functions.
引文
[1]宁新庆.前后路联合手术治疗颈椎骨折脱位并脊髓损伤的临床疗效[J].临床研究,2017,25(2):108-109.
[2]俞莉敏,吴海龙,汤晨逢,等.手术联合NGF治疗无骨折脱位型颈脊髓损伤的临床疗效分析[J].临床医学工程,2017,24(4):475-477.
[3]Li Haoxi,Yong Zhiyao,Liu Tao,et al.Preventive treatment with cervical stenosis of the cervical spinal cord injury without fracture and dislocation of the assessment[J].Journal of practical medicine,2017,33(1):112-114.
[4]谭荣,马华松,吴继功,等.无骨折脱位颈脊髓损伤颈髓MRI表现与治疗策略[J].临床骨科杂志,2016,19(6):648-650,653.
[5]李学阳.前后联合手术入路治疗颈椎骨折脱位并脊髓损伤的效果[J].河南外科学杂志,2016,22(6):43-44.
[6]吕召民.颈椎椎板切除术联合侧块螺钉内固定治疗无骨折脱位型颈髓损伤[J].骨科,2016,7(6):408-411.
[7]乔剑波,刘凯.小儿非脊柱骨折脱位型脊髓损伤康复治疗的临床效果[J].中国社区医师,2016,32(35):188-189.
[8]Zhou Yingjie,Chai Xubin,Zheng Huailiang,et al.Anterior approach distraction reduction and fixation for fracture and dislocation of lower cervical spine with facet locking[J].chin J trauma,2016,32(11):1002-1008.
[9]闫亮,贺宝荣,郭华,等.不同手术入路治疗颈胸段脊柱骨折的疗效比较[J].中华创伤杂志,2016,32(11):995-1001.
[10]陆林,叶哲伟,安颍,等.Ⅰ期前后路联合手术治疗复杂下颈椎骨折脱位伴关节突绞锁[J].临床外科杂志,2016,24(11):875-878.
[2]俞莉敏,吴海龙,汤晨逢,等.手术联合NGF治疗无骨折脱位型颈脊髓损伤的临床疗效分析[J].临床医学工程,2017,24(4):475-477.
[3]Li Haoxi,Yong Zhiyao,Liu Tao,et al.Preventive treatment with cervical stenosis of the cervical spinal cord injury without fracture and dislocation of the assessment[J].Journal of practical medicine,2017,33(1):112-114.
[4]谭荣,马华松,吴继功,等.无骨折脱位颈脊髓损伤颈髓MRI表现与治疗策略[J].临床骨科杂志,2016,19(6):648-650,653.
[5]李学阳.前后联合手术入路治疗颈椎骨折脱位并脊髓损伤的效果[J].河南外科学杂志,2016,22(6):43-44.
[6]吕召民.颈椎椎板切除术联合侧块螺钉内固定治疗无骨折脱位型颈髓损伤[J].骨科,2016,7(6):408-411.
[7]乔剑波,刘凯.小儿非脊柱骨折脱位型脊髓损伤康复治疗的临床效果[J].中国社区医师,2016,32(35):188-189.
[8]Zhou Yingjie,Chai Xubin,Zheng Huailiang,et al.Anterior approach distraction reduction and fixation for fracture and dislocation of lower cervical spine with facet locking[J].chin J trauma,2016,32(11):1002-1008.
[9]闫亮,贺宝荣,郭华,等.不同手术入路治疗颈胸段脊柱骨折的疗效比较[J].中华创伤杂志,2016,32(11):995-1001.
[10]陆林,叶哲伟,安颍,等.Ⅰ期前后路联合手术治疗复杂下颈椎骨折脱位伴关节突绞锁[J].临床外科杂志,2016,24(11):875-878.