颈髓损伤循证治疗的实践策略

目的探讨颈髓损伤循证治疗的实践策略。方法2013年1月3日收治1例颈髓损伤患者，全面评估病情，检索数据库获得循证医学证据，制定最佳治疗策略，治疗始末均全面实施该方案，评价治疗结局。结果根据检索循证医学证据，颈髓损伤治疗目标即挽救残留功能、防治并发症，努力促进神经功能恢复。依据实时病情，循证制定动态治疗方案，实施包括绝对卧床休息、颈部制动、大剂量激素冲击、神经营养药物、辅以中医药康复、并发症防治处理等循证综合治疗。经半年左右随访，患者病情稳定，可下床站立及行走，已恢复一定生活自理能力。结论应用循证医学方法制定颈髓损伤循证治疗策略，保证患者最大程度受益，更具科学性，值得推广。

Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury

Objective To explore the practice of the evidence-based treatment strategy for cervical spinal cord injury. Methods One patient with cervical spinal cord injury was admitted to our hospital on January 3, 2013. We obtained medical evidences by searching databases and regulated the best treatment after evaluating the patient＇s comprehensive conditions. And then, the whole treatment strategy was fully implemented. Finally, the consequent results were evaluated. Results The evidence-based medicine showed that the therapeutic targets were to save the residual function, prevent complications, and promote the recovery of neural function. Based on the real-time conditions of patient, we developed and practiced the evidence-based comprehensive rehabilitation programs, including absolute rest in bed, high-dose steroids, neurotrophic drugs, Chinese medicine rehabilitation and prevention of complications. After a follow-up of half a year, the patient obtained a good curative effect. The patient was saved from paralyzing. Moreover, the patient restored the capacity of standing, walking and a certain level of self-care ability. Conclusions For the cervical spinal cord injury, treatment decision based on evidence-based medicine is more scientific, and it can ensure maximum benefit for the patients. Therefore, it is worthy of popularizing.