鞘注甲氨蝶呤或阿糖胞苷污染微量长春新碱所致脊髓损伤不良事件患者半年随访观察

目的：初步观察鞘注甲氨蝶呤或阿糖胞苷污染微量长春新碱所致脊髓损伤患者半年预后情况。方法： 选取三个省份6家医院内发生的29例不良事件患者为随访对象。随访观察时间选择在出现神经损害症状后的6个月进行。由神经内科医生评价患者神经损害症状的转归、恢复情况，填写统一的设计问卷。结果：截止到随访时，该不良事件患者有2例死于原发恶性血液病，22例（81%）发生肌肉萎缩；6例（22%）完全性截瘫，21例（78%）为不完全性截瘫，7例二便障碍（26%）。采取多重治疗方式后，40%存活患者的肌力有改善，不完全截瘫患者肌力改善情况较好。结论：该不良事件病例，脊髓损伤半年后仍遗留不同程度的神经功能残障，预后不良；发生后应积极采取一些脊髓损伤的保护措施，有利于改善损伤病例的康复与预后。

Observation of the Patients with Adverse Events in Spinal Cord Injury Induced by Trace Vincristine contaminated with Intrathecal Methotrexate and Cytosine Arabinoside

ABSTRACT Objective::To analyze the prognosis of the patients who were victims of trace vincristine adverse events contamintated with intrathecal methotrexate and cytosine arabinoside through 6 months follow up observation.Methods:29 patients defined as the drug induced adverse events were selected from 16 hospitals in three provinces for the observation of the prognostic situation of patients in 6 months after the event onset to introduce a face to face follow up study. The nerve functional recovery of spinal cord in patients were evaluated by neurologists filling in a unified questionnaire. Results:2 patients died from original malignant hematologic disease, 22 (81%) suffered from muscle amyotrophy, 6 (22%) had complete paraplegia, 21(78%) had incomplete paraplegia, and 7 (26%) had urinating and rectum dysfunction during the follow up visits. 40% of the survival patients improved their muscle strength after multiple therapy, especially those with incomplete paraplegia improved even better. Conclusion: The adverse event cases with poor prognosis in the 6 months term still remained to have their distinct disability of spinal cord with nerve functional handicap. It might be helpful for recovery and prognosis to take some active protective measures as soon as the acute spinal cord injuryit occurred.