1352例急性脊柱脊髓损伤早期救治分析

目的 分析急性脊柱脊髓损伤的伤情、合并伤和并发症，提出早期治疗原则。方法 对1352例急性脊柱脊髓损伤病例进行回顾性分析。结果 脊髓完全性损伤875例、不完全性损伤477例；合并症有肺部感染、泌尿系感染、褥疮等；合并伤有颅脑损伤、四肢骨盆骨折、血气胸等。保守治疗包括大剂量甲基强的松龙冲击疗法、高压氧治疗、脱水剂、神经营养药物等；对存在脊柱不稳、脱位和脊髓压迫者，进行减压内固定手术；合并伤均给予专科处理。结论 应重视急性脊柱脊髓损伤的现场急救，进行及时正确的早期处理；应重视处理合并伤，预防脊髓继发性损伤和并发症；早期康复指导是提高救治水平的关键。

Analysis of early treatment on 1352 cases with acute spinal cord injury

ObjectiveTo analyse the state of traumatic conditions, associated injury and complications of patients with acute spinal cord injury (SCI) and provide the therapeutic principles of early treatment.Methods1352 cases with acute SCI were studied retrospectively.ResultsAmong patients, 875 cases had complete SCI and 477 cases had incomplete SCI. Complications included pulmonary infection, urinary system infection, bedsore and so on. The associated injuries included craniocerebral injury, fractures of limbs and pelvic, hemopneumothorax and so on. Conservative treatments involved high doses of methylprednisolone pulse therapy (MPPT), hyperbaric oxygen treatment (HOT), the use of dehydrating and neurotrophy agents, etc. The operation of decompress and internal fixation was applied in cases with spinal instability, vertebral dislocation and spinal compression. The associated injury was treated by specialist.ConclusionThe key point of raising remedy level includes thinking highly of field first aid, prompt and perfect early treatment, dealing with associated injury, preventing secondary SCI and complications and early rehabilitation directions. [