急性横贯性脊髓炎感染特点及临床疗效

Charactoristics and clinical thercepeutic effect of acute across myelitis

目的探讨急性横贯性脊髓炎感染特点及临床治疗,为临床诊疗提供参考依据。方法回顾性分析2010年8月-2013年8月收治的70例急性横贯性脊髓炎患者资料,将其按照治疗方案不同分为A、B两组,每组各35例,观察两组临床治疗效果,采用SAS14.0软件进行统计分析。结果 70例急性横贯性脊髓炎患者中首发症状以运动障碍为主,占55.71%,其次为感觉异常占18.57%;感染病毒以Ⅱ型单纯疱疹病毒为主,占38.57%,其次为柯萨奇病毒和水痘带状疱疹病毒,分别占25.71%和21.43%;A组患者治疗总有效率为97.15%,优于B组患者总有效率的77.14%,差异有统计学意义(χ2=6.2477,P<0.05),A组患者肌力恢复时间、留置导尿时间和住院时间分别为(10.14±2.09)d、(12.63±3.17)d、(15.32±2.83)d,均短于对照组,差异有统计学意义(P<0.05)。结论急性横贯性脊髓炎临床表现一般取决于受累的脊髓节段与病变的范围,采用甲基强的松龙进行治疗疗效可靠,能够缩短肌力恢复时间、留置导尿时间和住院时间,值得在临床上大力推广使用。

OBJECTIVE To study of characteristics treatment of acute myelitis infection, to provide a reference basis for clinical treatment. METHODS A total of 70 patients with acute myelitis from Aug. 2010 to Aug. 2013 were retrospectively analyzed, according to the different treatment were divided into group A and group B, 35 cases for each group, two groups of clinical curative effect were observed. SAS 14. 0 software was used for statistic analysis. RESULTS The initial symptom in 70 cases of patients was movement disorders, accounting for 55.71~, followed by paresthesia（18.57~）. The infected virus were mainly type 2 Herpesvirus hominis, accounting for 38.57~//oo, followed by coxsackievirus and Varicella-zoster virus, accounting for 25.71~ and 21.43~. The total effective rate in group A was 97.15 % significantly, better than B group 77.14 X, （Z2- 6. 2477,P〈0.05）. The muscle recovery time （10.14~2.09） d, indwelling catheter time （12.63=t=3.17） d, length of hospital stay （15.32 ＋2.83） d in group A were all singnificatly shorter than those in control （P〈0.05）. CONCLUSION The clinical manifestations acute across myelitis generally depends on the the spinal cord segment involved and the range of lesions, using methyl prednisolone is more reliable, which can shorten the myodynamia recovery time, indwelling catheter time and length of hospital stay, and this method should be promoted vigorously in clinic.