脊髓缺血再灌注损伤的发病特点与治疗

目的：通过临床资料分析探讨脊髓缺血再灌注损伤（spinalcordischemia-reperfusioninjury， SCII）的发病特点及治疗。方法回顾性分析2003年1月至2013年9月，我院脊柱外科发生的6例SCII临床资料，年龄56～78（63＆#177;3.5）岁，6例均于术后2h内出现SCII，收集资料并对病史特点、治疗及预后进行客观分析。结果6例脊髓减压术后1～2h脊髓功能呈进行性丧失，发生SCII后立即给予大剂量甲泼尼松龙、脱水、营养神经类药物使用后脊髓功能逐渐恢复，术后14～24天脊髓功能恢复正常。结论脊髓缺血再灌注损伤好发于中老年颈胸段，损伤程度可能与脊髓生理解剖特点、脊髓压迫程度、范围、时间以及围手术期治疗相关。其诊断需要结合病史、临床症状及影像学资料，缺一不可。SCII发生后甲泼尼松龙的治疗是有效的。

Onset features and the treatment of spinal cord ischemia-reperfusion injury

Objective To analyze and investigate the onset features and the treatment of spinal cord ischemia-reperfusion injury （ SCII ） based on the clinical data. Methods The clinical data of 6 patients with SCII who were adopted from January 2003 to September 2013 were retrospectively analyzed. Their mean age was （ 63＆#177;3.5 ） years old （ range;56-78 years ）. SCII occurred to all the 6 patients within 2 hours after the operation. The data was collected, and the medical history characteristics, treatment and prognosis were objectively analyzed. Results The spinal cord dysfunction was gradually aggravated in the 6 patients at 1 to 2 hours after the spinal cord decompression surgery. All the patients were treated with large doses of methylprednisolone （ MP ）, dehydration and neuronutritional medicine immediately. Thanks to the treatment, all of them were well recovered at 14 to 24 days after the surgery, and the normal spinal cord function was restored. Conclusions SCII mainly occurs in cervical and thoracic segments of the middle-aged and elderly patients. The degree of injury may be relevant to the anatomical and physiological characteristics, the degree, range and time of spinal cord compression and the perioperative treatment. The medical history, clinical symptoms and imaging data should be considered in the diagnosis. The MP is effective in the treatment of SCII .