影响马尾综合征预后的相关因素分析

背景马尾神经综合征(CES)手术减压后可最大限度的减少神经症状的残留,但仍有很多因素影响其疗效.目的探讨影响马尾综合征疗效的重要因素,提高该病的治愈率.设计以诊断为依据的回顾性研究.地点和对象本研究在西安交通大学第二医院骨二科完成,对象为1990/2000收治的马尾神经综合征患者24例,男14例,女10例.方法对24例马尾综合征患者进行为期2年随访,采用Logistic回归分析病因、发病部位、病情轻重、起病急缓、手术时机等5项因素,进行统计学处理.主要观察指标6例残留症状的影响因素及其相关分析.结果效果良好无残留症状者18例,留有不同程度的括约肌功能障碍和拇背伸力减弱6例.残留症状影响因素非条件Logistic回归分析结果,入选回归模型的因素仅有原发病史和CES史2项.结论减压手术时间和发病急缓是影响该病疗效的主要因素.

Analysis of therelated factors influencing the prognosis of cauda equina syndrome

BACKGROUND: The residual nerve symptoms of cauda equina syndrome (CES) can be reduced to the utmost by decompression, but there are still many factors that influence the curative effect.OBJECTIVE: To investigate the important factors that influence the curative effect of CES in order to increase the curative rate of the disease.DESIGN: A retrospective study based on diagnosis was conducted.SETTING and PARTICIPANTS: The study was completed in the Second Department of Orthepaedics, the Second Hospital of Xi' an Jiaotong University. The subjects were 24 hospitalized patients with CES admitted and treated from 1990 to 2000, 14 males and 10 females.METHODS: Twenty-four patients with CES had been followed up for 2 years. Logistic regression analysis was used to analyze the cause, site and state of the disease, the mode of onset and the opportunity of operation.MAIN OUTCOME MEASURES: The influence factors of 6 patients with residual symptoms and the related analysis.RESULTS: Eighteen patients got satisfactory effect without residual symptoms. Six patients were still with dysfunction of sphincter muscle and attenuation of dorsal extensor strength of different degrees. The results about the factors that influenced the residual symptoms were analyzed with unconditional logistic regression analysis. Factors that were selected into the regression model were only the primary medical history and CES history.CONCLUSION: The opportunity of decompression and the mode of onset are the main factors that influence the curative effect on the disease.