急性颈脊髓损伤并呼吸功能障碍高危因素分析

目的分析急性颈脊髓损伤后并发呼吸功能障碍的高危因素,以减少呼吸功能障碍发生,降低死亡率。方法对2002年7月-2006年8月收治的48例急性颈脊髓损伤患者,根据瘫痪程度、脊髓损伤平面、吸烟及年龄与呼吸功能障碍发生率的相关性,采用维持有效呼吸、颈部制动、减压复位内固定等相关措施,减少颈脊髓损伤患者术后并发呼吸功能障碍的发生。结果 22例发生呼吸功能障碍;9例死亡,其中7例死于呼吸衰竭,1例心跳骤停死亡,1例合并脑干损伤死亡。结论全瘫、脊髓损伤平面高、吸烟、高龄是急性颈脊髓损伤并发呼吸功能障碍的高危因素,对高危患者气管切开、呼吸机辅助呼吸态度应积极。

Analysis of High Risk Factors of Respiratory Obstacle after Acute Cervical Spinal Cord Injury

Objective To analyze the high risk factors of respiratory obstacle after acute cervical spinal cord injury（SCI）and accept the measure more actively so as to decrease the respiratory obstacle occurrence and reduce the mortality rate.Methods A total of 48patients from July 2002to August 2006were analyzed.According to the correlation among the paralyze degree,smoking,and age with the respiratory obstacle occurrence,we reduce the occurrence of respiratory obstacle in patients with spinal cord injury after the operation via obtaining the effective breath,neck retaining,etc.Results The respiratory obstacle was found in 22cases;death in 9,in whom 7died of respiratory failure,1of cardiac arrest,and 1of brain stem hurt.Conclusions The whole palsy,higher level of the spinal cord injury,smoking,and advanced age are the high risk factors of respiratory obstacle after acute cervical SCI.The tracheostomy tube and the adjuvant respiration with the respirator should be accept aggressively for those high risk patients.