颈中央脊髓损伤综合征的远期疗效及预后影响因素

Analysis of influencing factors of long-term efficacy and prognosis of central cord syndrome

目的:评估颈中央脊髓损伤综合征(CCS)的远期疗效,分析其疗效及预后的影响因素。方法:回顾性分析2008年1月至2011年12月在宁波大学医学院附属医院接受住院治疗的72例CCS患者的资料。运用JOA评分法对入院及末次随访时患者神经功能进行评估,采用简单线性回归分析和多重线性回归分析对可能影响疗效及预后的因素进行单因素及多因素分析。结果:末次随访时JOA评分均值由治疗前的(10.13± 3.54)分增加至(14.14±2.53)分,JOA改善率为(59.49±31.80)%。手术治疗患者JOA改善率明显优于保守治疗,差异有统计学意义(P<0.05)。在对各项疗效及预后因素进行简单线性回归分析和多重线性回归分析后显示,年龄与治疗方式是疗效的影响因素,入院JOA评分、激素冲击治疗是预后的影响因素。结论:年龄较大的患者疗效较差,手术治疗的疗效优于保守治疗,而初始神经功能损害程度较重、接受激素冲击治疗的患者往往预后越差。

Objective： To evaluate the long-term efficacy of central cord syndrome （CCS） and analyze the infuencing factors of long-term effcacy and prognosis. Methods： We retrospectively analyzed the data of 72 patients with CCS who were hospitalized at the Affiliated Hospital of Medical School of Ningbo Univer-sity from January 2008 to December 2011. The neurological function of the patients was assessed by the JOA score method on admission and at the fnal follow-up. Univariate and multivariate analysis was performed using simple linear regression analysis and multiple linear regression analysis. Results： At the fnal follow-up visit, the mean JOA score increased from （10.13± 3.54） points to （14.14±2.53） points, and the JOA improvement rate was （59.49±31.80）%. The JOA improvement was signifcantly better than conservative treatment in the patients un-dergoing surgery. The difference was signifcant （P〈0.05）. After simple factor linear regression analysis and mul-tivariate linear regression analysis of the various factors infuencing the long-term effcacy and prognosis, it was shown that age and treatment were independent factors of the effcacy, and admission JOA score and hormone shock therapy were independent factors of the prognosis. Conclusion： It is less effective in the elder patients. Surgical treatment is superior to conservative treatment. Patients with severe initial neurological impairment and hormone shock treatment often have poorer prognosis.