颈脊髓损伤早期死亡临床研究

Clinical research of early death in cervical spinal cord injury

目的分析研究颈脊髓损伤(CSCI)早期死亡情况,探讨颈脊髓损伤早期死亡的主要影响因素及发生机理。方法收集整理2004-02-2012-02入院的131例CSCI患者的临床资料(早期死亡15例),分析CSCI早期死亡者的年龄、性别、受伤原因、脊柱损伤节段、脊髓损伤严重程度、是否手术及气管切开、是否存在低钠血症、是否存在低蛋白血症与CSCI早期死亡的关系,总结CSCI早期死亡的原因。结果 CSCI早期死亡率为8.40%(11/131),多死于呼吸功能衰竭。性别、受伤原因及是否手术统计分析,差异无统计学意义(P>0.05);颈髓不同损伤程度、颈髓不同损伤节段、不同年龄段、气管是否切开、是否存在低钠血症及是否存在低蛋白血症统计分析,差异有统计学意义(P<0.05或P<0.001)。结论呼吸衰竭是CSCI早期死亡的首要原因;颈髓不同损伤程度、颈髓不同损伤节段、不同年龄段、气管是否切开、是否存在低钠血症、是否存在低蛋白血症是CSCI早期死亡的主要影响因素。

Objective The research has been launched to analyze the critical condition of early death caused by cervical spinal cord injury（CSCI） and explore the main influencing factors and intrinsic mechanisms underlying it. Methods There were totally 131 CSCI cases which have been collected from Feb. 2004 to Feb. 2012 （early death 11 cases）. The relationship among the early death and patient＇s age,sex,injured causes, location of spine injury, degree of the injury,incision of trachea（operation）,hyponatremia as well as hypoproteinemia has been comprehensively analyzed to summarize the main cause of CSCI early death.Results The early death rate of CSCI was 8.40% （ll/131）and most cases died from respiratory failure,The difference were not statistically significant among sex difference,iujured causes,operation or not （P〉O.OS）.Meanwhile,it was statisticaUy significant in injury degree,injury location, injury age,hyponatremia,or not,hypoproteinemia or not,incision of trachea or not （P〈O.05 or P〈0.001）. Conclusion The injury degree,injury location,injury age and hyponatremia,hypoproteinmia,incision of trachea played a very important role in nonage death in CSCI and the first death reason was respiratory failure.