脊髓锐器伤的诊断与治疗特点

目的探讨脊髓锐器伤的损伤特点、临床表现、治疗及预后。方法对1992年至2004年12年间42例脊髓锐器伤的临床资料进行回顾性分析。结果本组男性病例38例,女性4例,平均年龄23.6岁。脊髓损伤节段在胸段脊髓者32例（占76.0％）;完全性损伤12例（占28.6％）;不完全性损伤30例（占71.4％）。不完全损伤中典型Brown-Sequard综合征14例（占46.7％）;不典型Brown-Sequard综合征6例（占20.0％）;非Brown-Sequard综合征10例（占33.3％）。MRI对指导脊髓锐器伤的诊断和治疗价值很大;急性期常规行清创缝合术,根据具体情况,行椎管探查、血肿清除、异物取出等手术;经过治疗与康复,本组病例入院和出院的ASIA评分和ADL评分都有明显提高。结论临床上处理脊髓锐器伤病例时,要根据其特点了解在诊断和治疗上特殊性,以便更快更有效地促进此类脊髓损伤的功能恢复。

Characteristic of diagnosis and treatment of spinal cord stab injury

Objective To investigate the clinical characteristics of the incidence, diagnosis, treatment and prognosis of stab injury of spinal cord. Methods Retrospective study of the clinical materials of 42 stab spinal cord injury patients who were treated in our hospital from 1992 to 2004. Results Among the patients, 38 were male, and 4 were femal. 80% of the cases were thoracic spinal cord injury patients. Incomplete injury cases accounted for 71.4% of all the cases. Of all the 30 incomplete injury cases, 14 had the sign of standard Brown-Sequard syndrome,6 had the sign of non-standard Brown-Sequard syndrome and 10 do not have the sign of Brown-Sequard syndrome. Maganetic resonance image was very useful to the diagnosis and treatment of the disease. Debridement was a routine to do in acute stage. Operations such as scrutinization of the spinal canal, clean-up of the hematoma, extration of foreign bodies were optional according to different conditions. After treatment, most of the patients got good recovery as far as ASIA scale and ADL scale were concerned. Conclusion According to the results above,it is recommended that enough attention should be given to the unique aspects of the disease to effectively facilitate recovery of such cases.