颈髓损伤患者循环系统动态变化的临床研究

Clinical study of dynamic change of circulation system in the patients with cervical spinal cord injury

目的 探讨颈髓损伤 (ＣＳＣＩ)后循环系统的动态变化。方法 回顾性对比分析了 47例ＣＳＩ患者与 57例非ＣＳＣＩ患者血压、心率、心电图的动态变化以及ＣＳＣＩ平面、颈髓反射复前后对血压、心率、心电图的影响。结果 ＣＳＣＩ患者血压、心率明显降低 (Ｐ < 0 . 0 1 );颈4以上比颈 4以下损伤患者的血压、心率下降更为明显 (Ｐ < 0 . 0 5);心电图除出现窦性心动过缓改变外 ,同时还出现ＳＴ段下移、Ｔ波低平 ,Ｕ波、ＱＲＳ波、Ｑ -Ｔ间期时限延长等心电异常表现 (Ｐ < 0 . 0 1 )。颈髓反射恢复后血压、心率明显升高 (Ｐ <0 . 0 1 ),心电图恢复正常 (Ｐ< 0 . 0 1 )。结论 ＣＳＣＩ后循环系统功能有明显异常改变 ,主要发生在脊髓休克期 ,且损伤平面越高 。

Objective To assess the effects of cervical spinal cord injury(CSCI) on circulation system. Methods 47 cases with acute CSCI were retrospectively studied on dynamic change of BP,HR,ECG and the effect of plane in CSCI on dynamic change of BP,HR,ECG. Results The BP,HR in patients with CSCI decreased significantly(P<0.01); The BP,HR in patients with CSCI above the fourth cervical spinal were significantly lower than those below the fourth(P<0.05); The rate of bradycardia,S-T segments depressing,T wave depressing, time limit of U wave,QRS complex, Q-T interphase prolonging in ECG of patients CSCI was higher than non-CSCI(P<0 01).The BP,HR were significantly higher after spinal reflection comeback than before(P<0 01).Conclusion There are significantly anomalous changes on circulation system after CSCI, especially in the shock period of spinal cord. More unstable the function of circulation system is,the higher the plane of CSCI is.