颈椎骨折合并脊髓损伤病人的围手术期处理

目的 探讨颈椎骨折合并脊髓损伤病人围手术期并发症的处理措施.方法 1999年1月-2005年12月手术治疗颈椎骨折合并骨髓损伤病人226例,206例行前路减压植骨内固定术,18例行前后路联合手术.结果 高热79例,呼吸功能障碍144例,肺部感染42例,低钠血症102例,泌尿系感染20例,应激性溃疡6例,深静血栓3例,喉上或喉返神经损伤6例,脑脊液漏3例,颈部血肿2例,内固定物松动2例,死亡12例.结论 颈椎骨折合并脊髓损伤病人围手术期并发症非常多,重视围手术期并发症的处理是提高临床疗效的保障.

Treatment of Cervical Fractures with Spinal Cord Injury during Perioperative Period

Objective To investigate the complications and their therapeutic strategy of cervical fractures with spiral cord injury during perioperative period. Methods Between January 1999 and December 2005, 226 patients of cervical fractures with spinal cord injury were treated, two surgical procedures were performed: Anterior decompression and interbody fusion with plate fixation in 206 cases, combined with posterior reduction and decompression in 18 cases.Results Many patients were complicated by the following diseases: high fever(79),respiratory functional disorder(144), pneumonitis(42),hyponatremia(102),infection of urinary system(20),Stress ulcer(6),deep vein thrombi(3),superior laryngeal or recurrent laryngeal nerve injury(6), leakage of cerebrospinal fluid(3),haematoma(2), loosening of plate fixation(2), death(12).Conclusion The complications of cervical fractures with spinal coral injury were various during perioperative period. The management of complications during perioperativeperil was vary important to improve the clinical outcomes.