脊髓损伤早期的预后判断

Early prognosis prediction after spinal cord injury

目的：对脊髓损伤早期的预后判断提出再讨论。方法：对１１０例脊髓伤患者进行病史调查，损伤早期（２～３ｄ）神经损害按完全性及不完全性分组及ＡＳＩＡ损伤程度分级，伤后９个月至３年随访的神经功能采用Ｂｅｎｚｅｌ分类，定义患者显著恢复的标准，分析术后早期脊髓损害程度和显著恢复率的对应关系。结果：脊髓完全损伤组的显著恢复率为５．７％，中央损伤综合征为５０．０％，半切损伤综合征为６２．５％，前部损伤综合征为１０．０％。结论：脊髓损伤早期的预后判断要点应抓住脊髓休克末期，分清骶髓幸免和骶髓反射，对脊髓损伤作正确的分类，则可以尽早地大致预言远期恢复率。

Objective: To present a rediscussion of prognosis prediction after spinal cord injury. Methods:Their neurological function in early stage was investigated and classified as complete and incomplete syndromes, and was graded by ASIA impairment scale. Their neurologcal function at 9 or more months after injury was evaluated by Benzel classification. A marked recovery rate(MRR) was defined as the percentage of marked recovered cases in the groups. Results: In our series, the MRRs for complete injury group, BrownSequard's syndrome group, central syndrome group, and anterior syndrome group were 5.7%, 62.5%, 50.0% and 10.0%, respectively. Conclusion: In order to early predict prognosis after spinal cord injury, the emphasis should be put on timely identifying the end of spinal cord shock, distinguishing the sacral sparing from sacral reflexes, and precise classification of early neurological function below injury level.