颈脊髓损伤血液动力学变化

Changes of hemodynamic parameters in acute cervical spinal cord injury

[目的]探讨颈脊髓损伤的严重性(Franke1分级)与患者血液动力学变化的关系。[方法]颈脊髓损伤患者入院后进行连续7 d心电监护测量血压、心率取平均值,并作为统计参数。患者神经功能根据美国脊髓损伤协会(American Spinal Injury Association,ASIA)损伤系统分级法,其中Franke1 A 31例,Franke1 B 19例,Franke1 C/D 28例。患者平均年龄36.5岁(16～78岁),平均随访时间30个月(12～60个月)。[结果]Franke1 A组出现低血压和心动过缓病例和Franke1 B,Franke1 C/D组比较,有显著差异性(P<0.05)。[结论]颈脊髓损伤后可引起植物神经系统功能障碍,常发生心血管功能紊乱,临床表现为低血压、心动过缓。详细评价颈脊髓损伤后自主神经功能紊乱所致的心血管功能不稳定,能够帮助了解患者临床症状的复杂性和可能的神经结果。

[ Objective ] To evaluate the relationship between the severity of cervical spinal cord injury （SCI） and hemody- namic parameters changes. [ Method] Blood pressure（BP） and heart rate（HR） were taken once daily during the first 7 days in hospital persist warding the electrocardiogram. The mean value of the hemodynamic parameters were choosen as statistic data. The neurologic clinical status of patients was assessed according to the American Spinal Injury Association（ASIA） impairment scale. Severe complete SCI（Frankel grade A）was determined in 31 patients of these patients,frankel B in 19 patients ,Frankel C,/D in 28 patients. The mean patient age was 36.5 years （range of 16 -78 ）. [ Result] The occurrence of hypotension and brad- ycardia revealed a statistically significant difference among Frankel A, Frankel B and C/D（ P 〈 0.05 ）. [ Conclusion] Dysfunc- tion of cardiovascular system usually develops in patients with cervical SCI, the main clinical presentations are hypotension and bradycardia. Detailed evaluation of autonomic dysfunctions following SCI cardiovascular instability can improve our understand- ing of the complicated of clinical presentations and possible neurological impairment.