急性脊髓损伤手术前后综合处理对患者并发症的影响

目的:探讨急性脊髓损伤围手术期处理对患者并发症的影响。方法:对第四军医大学唐都医院1995-2000年收治的急性脊髓损伤患者117例进行回顾性分析。结果:手术前后呼吸系统的并发症为38.7%,其他系统的并发症为10.2%,围手术期死亡10例,死亡率8.6%,117例患者治疗前后按Frankel功能评价,效果相差显著(χ2=97.627,P<0.01);功能的独立性按FIM评分检验,治疗前后功能的依赖性相差显著(χ2=148.993,P<0.01)。结论:急性脊髓损伤的患者极易并发全身性炎症反应(SIRS),SIRS是急性呼吸窘迫综合征(ARDS)和多器官功能障碍(MODS)的始动因素,手术前后严密监测SIRS及ARDS是围手术期治疗的关键,早期的康复综合治疗是患者预后的保障。

Effects of perioperative management of acute cervical spinal cord injury on secondary complications

AIM:To investigate the effect of perioperative management of acute cervical spinal cord injury on secondary complications of patients. METHODS:The clinical data of 117 patients recruited from 1995 to 2000 were analyzed retrospectively. RESULTS:The respiratory complications before and after operation accounted for 38.7% ; the other systematic complications accounted for 10.2 % .During the perioperative period,10 patients were dead with the mortality rate 8.6 % . The function on Frankel criterion between postoperation and preoperation was obviously different(χ 2=97.627,P< 0.01);the dependence on FIM criterion was also obviously different(χ 2=148.993,P< 0.01). CONCLUSION: SIRS occurs easily during the perioperative period among the patients with acute cervical spinal cord injury,which is the starting cause of the ARDS and MODS. SIRS and ARDS should be supervised carefully before and after operation as the key of perioperative treatment.Early rehabilitation treatment is the guarantee of recovery of the patients.