颈椎脊髓损伤并呼吸功能不全的诊治

目的研究在基层医院对颈髓损伤并呼吸功能不全的诊断和治疗。方法15例患者采用颈前路椎体次全切除、植骨融合及钛钢板内固定术治疗,手术前后辅以机械通气。结果不完全损伤者6例,ASIA分级平均提高2级,5例生活可自理,其中2例恢复工作。完全损伤者9例,其中3例死亡,其余呼吸功能恢复正常,但ASIA分级无变化。结论早期诊断、早期手术减压并辅以机械通气法是治疗颈髓损伤并呼吸功能不全的关键。

Diagnosis and treatment of traumatic cervical spinal cord injury with respiratory insufficiency

Objective To study the diagnosis and treatment of traumatic cervical spinal cord injury with respiratory insufficiency in basic general hospitals. Methods 15 cases of traumatic cervical spine cord injury with respiratory insufficiency were treated with anterior decompression, bone graft and plate fixation. The mechanic ventilation was also used pre-and post-operatively. Results The neurological function of 6 cases with incomplete spine cord injury were improved by 2 grades according to ASIA evaluation post-operatively, among which 5 cases recovered their normal life, 2 returned to work. The other 9 cases with complete spine cord injury were found no ASIA grade change, among which 3 died and the other's respiratory function were recovered. Conclusion Early diagnosis and operation accompanied with mechanic ventilation is critical in treatment of traumatic cervical spinal cord injury with respiratory insufficiency.