马尾神经综合征发病机制的临床研究

Clinical Study of the Mechanism of Cauda Equina Syndrome

目的 :探讨马尾神经综合征临床发病特点 ,分析其发病机制。方法 :分析马尾神经综合征患者的临床表现、实验室检查和影像学检查的变化规律。结果 :马尾神经综合征的临床主要表现为鞍区感觉、大小便、性功能的障碍 ,首发症状为感觉功能的障碍 ,继而出现括约肌功能及性功能障碍。临床表现出现前BCR(bulbo cavernosus reflex)、ICR (is chio cavernosus reflex)等已有明显异常。影像学研究 ,大部分表现为多节段椎管狭窄。结论 :马尾神经综合征的机制是由于骶髓反射弧的广泛损害。马尾神经综合征分前期、早期、中期、晚期。电生理改变和鞍区感觉功能的改变是早期诊断的指标。在前期。

Objective:To study of pathology of caud a equina syndrome by clinical data.Methods:To probe into pathology of cauda equina sy ndrome by clinical features?laboratory tests?radiographic features and natural history.Result:The clinical symptoms of CES are manifested by low back pain,sci at ica,saddle and perineal hypoesthesia or anesthesia,a decrease in anal tone,absen t ankle,knee,or bulbocavernous reflexes,and bowel and bladder dysfunction.The li t erature continues to be conflicting.The first symptoms is saddle and perineal hy poesthesia or anesthesia.The second is a decrease in anal tone,absent ankle,kne e ,or bulbocavernous reflexes,and bowel and bladder dysfunction.Laboratory tests(b ulbocavernous refles,BCR)?ICR(ischiocavernosusreflex,ICR) had been abnomal befo re cauda equina syndrome.Conclusion:General injury of cauda equina and root of s pinal nerves and anterior horn of the sacral spinal cord lead to cauda equina sy ndrome.Cauda equina syndrome were divided into four stages,prior to clinical st a ge and clinical early stage?clinical midstage?clinical late stage. Cauda equina syndrome was diagnosed in laboratory stage or clinical early Stage,whichis stated as early diagnosis.