急性颈髓损伤后应激性溃疡的临床特点及治疗

目的 :总结急性颈髓损伤后应激性溃疡的临床特点及治疗体会。方法 :将 2 89例急性颈髓损伤患者按是否并发应激性溃疡 ,分为发病组和未发病组 ,并对两组的临床资料进行比较 ,其中包括 :性别、年龄、损伤平面、损伤程度、合并伤、并发症及早期应用激素。同时回顾性分析应激性溃疡的治疗方法。结果 :在年龄≥ 5 5岁、损伤平面在C4以上、完全性脊髓损伤、合并其它脏器损伤、并发肺内感染及早期应用大剂量甲基强的松龙方面 ,发病组与未发病组之间的差异具有显著性意义。经综合治疗 2 4h内出血停止 8例 ,2 4～ 48h出血停止 6例 ,48～ 72h出血停止 1例 ,1例因并发多脏器功能衰竭而死亡。结论 :急性颈髓损伤后应激性溃疡的发生与年龄、颈髓损伤的平面、损伤程度、合并伤、并发肺内感染及脊髓损伤后早期用药有关。诊断后应采取综合治疗

Diagnosis and therapy of stress ulcer after acute cervical spinal cord injury

Objective:To summarize the experience of clinical features and treatment of stress ulcer complicated with cervical spinal cord injury. Method: According to whether or not the patient complicated with stress ulcer, 289 patients of acute spinal cord injury were divided into two groups, illness group and no illness group, and compared the clinical data including sex, age, injured level, injured extent, associated other injury, complication, application of hormone. At the same time, retrospectively analyzed the treatment of stress ulcer. Result: There was significant difference between the two groups on these factors: age more than 55, injured level above the C 4, completely spinal cord injury, combined with other injury, complicated pulmonary infection, application of hormone. Fifteen patients were cured by conservative therapy, one patient died of respiratory and circulatory failure. Conclusion: The occurrence of stress ulcer after cervical spinal cord injury relates to age, cervical spinal cord injured level, injured extent, associated with other injury, complicated with pulmonary infection, application of hormone. Stress ulcer after cervical spinal cord injury is a very severe complication, and should be prevented and treated as early as possible.