颈髓损伤早期急诊手术的可行性及疗效评价

Evaluation of Feasibility and Treatment Efficacy of Immediate Spinal Cord Decompression for Acute Cervical Spinal Cord Injury

目的:探讨颈髓损伤早期急诊减压内固定手术的可行性及疗效。方法:回顾性分析2000年6月～2007年6月我科治疗的颈髓损伤患者68例,按是否进行急诊手术分为急诊手术组22例和非急诊手术组46例。所有患者均采集一般资料、神经功能状况(入院时和最后一次随访时)、术后并发症、重症监护时间和住院时间等临床资料,并进行统计学分析。结果:2组患者在一般资料、受伤节段、手术方式、随访时间及入院时神经功能状况等方面均无统计学差异;最后一次随访时2组相比神经功能无显著性差异,但急诊手术组的并发症发生率、重症监护时间和住院时间均低于非急诊手术组。结论:颈髓损伤后早期急诊手术可行、安全,有利于减少术后并发症,但对神经功能的恢复无明显帮助。

Objective： To evaluate the feasibility and treatment efficacy of early emergency surgical decompression and stabilization for acute cervical spinal cord injury. Methods： Sixty- eight patients with acute cervical spinal cord injury （June 2000-June 2007） were retrospectively reviewed, in which 22 cases underwent emergency operation （≤24 h after spinal cord injury） and 46 late operation （〉24h after spinal cord injury）. Detailed materials including general data, neurological function （in admission and in the most recent follow-up）, complications, intensive care time and hospital stay were collected and statistically analyzed in all the patients. Results： There was no significant differences in general data, distribution of the injury level, the operation meth- od, follow-up time and neurological functions at admission between two groups. In the emergency operation group, the neurological functions were similar to those in the late operation group, but the postoperative complications were less common and the intensive care time and hospital stay were shorter. Conclusions： Immediate spinal cord decompression and stabilization are feasible and safe for patients with cervical spinal cord injury. The early intervention can effectively decrease the postoperative complications. However, it shows no significant effects on neurologic recovery.