手术与非手术治疗中央型颈脊髓损伤的效果分析

目的 对比和分析手术和非手术方法治疗中央型颈脊髓损伤患者的临床效果.方法 选取本院收治的367例患者分为手术组与非手术组,均在受伤6h内采用甲泼尼龙冲击疗法、20％甘露醇脱水、营养神经治疗.非手术组在此治疗1～2周后即可出院,手术组在此治疗方案实施2～4 d后行手术治疗.结果 两组在手术、出院、随诊时的ASIA运动功能评分均高于人院前,差异有统计学意义（P＜0.01）;两组在治疗12个月时的ASIA运动功能评分均显著高于人院时,差异有统计学意义（P＜0.05）;手术组的恢复率为（67.3±6.8）％,非手术组的恢复率为（56.2±7.1）％,两组比较差异有统计学意义（P＜0.05）;手术组中无一例出现不良反应,非手术组中有47例患者出现迟发症状,不良反应率为25.40％.结论 采用手术治疗中央型颈脊髓损伤患者可以更为有效地提高临床效果及患者的生活质量,值得临床推广应用.

Effect analysis of operation and non-operation in the treatment of central cervical cord injury

Objective To compare and analyze effect analysis of operation and non-operation in the treatment of patients with central cervical cord injury. Methods Three hundred and sixty-seven patients admitted into our hospital were divided into operative group and non-operative group.All injured participants were provided with methylpred- nisolone shock therapy,20% mannitol for dehydration and trophic nerve therapy.Patients in the non-operative group were discharged from hospital after one or two week-treatment.In the operative group,operative treatment was performed after 2 to 4 days implementation of therapeutic regimen. Results ASIA motor scores in the operation,discharge,follow- up time of two groups was higher than that admitted to hospital respectively,with statistical difference （P〈0.01）.ASIA motor scores after treatment 12 months of two groups was higher than that admitted to hospital respectively,with statistical difference （P〈0.05）.Recovery rate in operative group was （67.3±6.8）%,while recovery rate in non-operative group was （56.2±7.1）%,with statistical difference （P〈0.05）.No adverse reaction occurred in operative group,but 47 cases presented with tardiness accounting for 25.40% in non-operative group. Conclusion Operative treatment for patients with central cervical cord injury can effectively improve clinical efficacy and quality of life,which is worthy of expansion and application in clinic.