老年CSCIWFD患者早期手术治疗的效果比较

Effects of early operative therapy in senile patients with CSCIWFD

目的探讨早期手术治疗无骨折脱位型颈脊髓损伤(CSCIWFD)老年患者的疗效。方法选择医院治疗的65例CSCIWFD老年患者,其中38例于颈脊髓损伤48 h内行手术治疗者为研究组,27例于颈脊髓损伤2~10 d内行手术治疗者为对照组,分别于治疗前和治疗后1 w、3个月、12个月,对患者进行颈椎JOA评分和运动功能评分,比较两组治疗后神经功能改善率。结果治疗前,两组JOA评分和运动功能评分无显著差异(P>0.05);治疗1 w、3个月、12个月,两组的JOA和运动功能评分均明显改善,且研究组的JOA评分和运动功能评分均显著高于对照组(P<0.05)。随着恢复时间的延长,两组的神经功能改善率逐渐提高,末次随访时,研究组和对照组的改善率分别为76.75%和35.60%,差异有统计学意义(P<0.05)。结论手术治疗CSCIWFD老年患者,可明显改善患者神经功能和运动功能,且治疗时间越早,恢复效果越好。

Objective To explore the effects of early operative therapy in senile patients with cervical spinal cord injury without fracture and dislocation（CSCIWFD）. Methods A total of 65 senile patients with CSCIWFD treated in our hospital were selected and divided into a study group（n=38） and a control group（n=27）. The study group received operative treatment within 48 hours upon the cervical spinal cord injury and the control group received operative treatment within 2-10 days upon the cervical spinal cord injury.Cervical spine JOA scoring and motor function scoring were conducted on patients one week, three months and 12 months before and after the treatment respectively to compare the improvement rate of neurological function between the two groups after the treatment.Results Before the treatment, there was no significant difference in the JOA score and motor function score between the two groups（P 〈 0.05）; one week, three months and 12 months after the treatment, the JOA and motor function scores in the two groups were significantly improved, and the JOA score and motor function score in the study group were significantly higher than those in the control group（P 〈 0.05）. With the extension of recovery time, the improvement rate of neurological function in the two groups was gradually improved. During the last follow-up visit, the improvement rate in the study group and the control group was 76.75% and35.60% respectively, and the difference was of statistical significance（P 〈 0.05）. Conclusion The operative treatment of CSCIWFD in senile patients can significantly improve the neurological function and motor function of patients. The earlier the treatment time, the better the recovery effects will be.