脊柱脊髓损伤伴多发伤的损伤程度评估及治疗结果评价

Evaluation of injury degree and treatment result of spinal cord injury with multiple injuries

目的探讨脊柱脊髓损伤伴多发伤的损伤程度评估及治疗结果评价。方法选取本院2016年3月至2017年2月收治的100例脊柱脊髓损伤伴多发伤患者作为本次的研究对象,在术前采用ASIA评分标准、ISS评分标准诊断评估患者,依据ISS评分标准分类,其中17～24分患者为A组(不全截瘫并发创伤组)、25～34分患者为B组(截瘫合并较为严重的多发性创伤组)、≥35分患者为C组(截瘫合并严重的多发性创伤组),并将3组术前、术后的手术损伤部位、评估情况、手术部位、住院天数及输血量进行对比。结果当手术部位的数量及损伤程度越为严重时,术后3组ASIA评分、ISS-AIS评分均高于术前,但A组受伤部位数、手术部位数、住院时间及手术输血量等指标,较B、C组差异有统计学意义(P<0.05);B、C组手术输血量对比差异无统计学意义。结论对于急性脊柱创伤合并脊髓损伤采取损伤控制具有显著的效果,实施术前的诊断评估方法具有重大的临床意义,有助于提高治疗的效果,值得在临床中推广实施。

Objective To evaluate the injury degree and therapeutic outcome of spinal cord injury with multiple injuries. Methods 100 cases of spinal cord injury with multiple trauma patients treated in our hospital were selected as the research object, from March 2016 to February 2017. In preoperative ASIA scoring criteria, ISS score standard diagnostic evaluation of patients, according to the standard classification ISS score, the 17-24 points patients were in group A (incomplete paraplegia complicated with trauma group), the 25-34 points were in group B (paraplegia with serious multiple trauma group),≥35 points were in group C (paraplegia with severe multiple trauma group), and three groups of preoperative and postoperative surgical injury, the situation assessment, surgical sites, hospitalization days and the amount of blood transfusion were compared. Results When the number of the surgical site and the damage degree more serious, postoperative ASIA score, ISS-AIS score in three groups were higher than preoperative, but there were significant differences in the number of injured area, the number of the surgical site and length of hospital stay, surgery transfusion volume in group A compared with group B and C (P<0.05);There was no significant difference in the amount of surgical blood transfusion between group B and group C. Conclusion The damage control method has significant effect on acute spinal trauma with spinal cord injury. The implementation of preoperative diagnostic assessment is of great clinical significance, help to improve the effectiveness of treatment, and is worth popularizing in clinical implementation.