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Pathophysiological mechanisms of chronic compressive spinal cord injury due to vascular events
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作者 Zhen-Xiao Ren Jing-Hui Xu +2 位作者 Xing Cheng Gui-Xing Xu Hou-Qing Long 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第4期790-796,共7页
Cervical spondylotic myelopathy is the main cause of non-traumatic spinal cord injury,with chronic static and/or dynamic compressive spinal cord injury as the unique pathogenesis.In the progression of this condition,t... Cervical spondylotic myelopathy is the main cause of non-traumatic spinal cord injury,with chronic static and/or dynamic compressive spinal cord injury as the unique pathogenesis.In the progression of this condition,the microvascular network is compressed and destroyed,resulting in ischemia and hypoxia.The main pathological changes are inflammation,damage to the blood spinal cord barriers,and cell apoptosis at the site of compression.Studies have confirmed that vascular regeneration and remodeling contribute to neural repair by promoting blood flow and the reconstruction of effective circulation to meet the nutrient and oxygen requirements for nerve repair.Surgical decompression is the most effective clinical treatment for this condition;however,in some patients,residual neurological dysfunction remains after decompression.Facilitating revascularization during compression and after decompression is therefore complementary to surgical treatment.In this review,we summarize the progress in research on chronic compressive spinal cord injury,covering both physiological and pathological changes after compression and decompression,and the regulatory mechanisms of vascular injury and repair. 展开更多
关键词 ANGIOGENESIS cervical spondylotic myelopathy HYPOXIA inflammation ISCHEMIA spinal cord injury surgical decompression
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Establishment and verification of a surgical prognostic model for cervical spinal cord injury without radiological abnormality 被引量:4
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作者 Jie Wang Shuai Guo +2 位作者 Xuan Cai Jia-Wei Xu Hao-Peng Li 《Neural Regeneration Research》 SCIE CAS CSCD 2019年第4期713-720,共8页
Some studies have suggested that early surgical treatment can effectively improve the prognosis of cervical spinal cord injury without radiological abnormality, but no research has focused on the development of a prog... Some studies have suggested that early surgical treatment can effectively improve the prognosis of cervical spinal cord injury without radiological abnormality, but no research has focused on the development of a prognostic model of cervical spinal cord injury without radiological abnormality. This retrospective analysis included 43 patients with cervical spinal cord injury without radiological abnormality. Seven potential factors were assessed: age, sex, external force strength causing damage, duration of disease, degree of cervical spinal stenosis, Japanese Orthopaedic Association score, and physiological cervical curvature. A model was established using multiple binary logistic regression analysis. The model was evaluated by concordant profiling and the area under the receiver operating characteristic curve. Bootstrapping was used for internal validation. The prognostic model was as follows: logit(P) =-25.4545 + 21.2576 VALUE + 1.2160SCORE-3.4224 TIME, where VALUE refers to the Pavlov ratio indicating the extent of cervical spinal stenosis, SCORE refers to the Japanese Orthopaedic Association score(0–17) after the operation, and TIME refers to the disease duration(from injury to operation). The area under the receiver operating characteristic curve for all patients was 0.8941(95% confidence interval, 0.7930–0.9952). Three factors assessed in the predictive model were associated with patient outcomes: a great extent of cervical stenosis, a poor preoperative neurological status, and a long disease duration. These three factors could worsen patient outcomes. Moreover, the disease prognosis was considered good when logit(P) ≥-2.5105. Overall, the model displayed a certain clinical value. This study was approved by the Biomedical Ethics Committee of the Second Affiliated Hospital of Xi'an Jiaotong University, China(approval number: 2018063) on May 8, 2018. 展开更多
关键词 nerve REGENERATION SURGICAL prognostic model cervical spinal cord injury retrospective study MULTIPLE binary logistic regression analysis bootstrapping internal validation MULTIPLE imputations cervical spinal stenosis duration of disease Pavlov ratio neural REGENERATION
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Anesthetic considerations for patients with acute cervical spinal cord injury 被引量:3
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作者 Fang-ping Bao Hong-gang Zhang Sheng-mei Zhu 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第3期499-504,共6页
Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology an... Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan.Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews,consider cervical spinal cord movement and compression during airway management,and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations.During induction,anesthesiologists should avoid hypotension and depolarizing muscle relaxants.Mean artery pressure should be maintained within 85–90 mmHg(1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management).Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained.Intraoperative neurophysiological monitoring is a useful option.Anesthesiologists should be attentive to postoperative respiratory insufficiency(carefully considering postoperative extubation),thrombus,and infection.In conclusion,anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome. 展开更多
关键词 nerve regeneration cervical spine injury cervical spinal cord injury spinal cord injury ANESTHESIA airway management INDUCTION INTUBATION NEUROPROTECTION neurophysiological monitoring NEUROPROTECTION neural regeneration
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Effects of decompression joint Governor Vessel electro-acupuncture on rats with acute upper cervical spinal cord injury 被引量:8
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作者 Yan-Lei Wang Ying-Na Qi +5 位作者 Wei Wang Chun-Ke Dong Ping Yi Feng Yang Xiang-Sheng Tang Ming-Sheng Tan 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第7期1241-1246,共6页
Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatme... Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury.Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord.In this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury.The rat models were established by inserting a balloon catheter into the atlanto-occipital space.The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression.Electroacupuncture was conducted at the acupoints Dazhui(GV14) and Baihui(GV 20)(2 Hz,15 minutes) once a day for 14 consecutive days.Compared with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture.However,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours.Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone.These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression(48 hours) is more effective in the treatment of upper cervical spinal cord injury.Governor Vessel electroacupuncture combined with early decompression(12 hours) can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury.Nevertheless,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone. 展开更多
关键词 nerve regeneration acute spinal cord injury decompression Governor Vessel electroacupuncture platelet-activating factor apoptosis methylprednisolone caspase family upper cervical spine animal model Basso Beattie and Bresnahan locomotor scale neural regeneration
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Effect of vocal respiratory training on respiratory function and respiratory neural plasticity in patients with cervical spinal cord injury:a randomized controlled trial 被引量:3
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作者 Xiao-Ying Zhang Wei-Yong Yu +7 位作者 Wen-Jia Teng Yi-Chuan Song De-Gang Yang Hong-Wei Liu Song-Huai Liu Xiao-Bing Li Wen-Zhu Wang Jian-Jun Li 《Neural Regeneration Research》 SCIE CAS CSCD 2022年第5期1065-1071,共7页
In previous studies,researchers have used singing to treat respiratory function in patients with spinal cord injury.However,few studies have examined the way in which vocal training affects respiratory neural plastici... In previous studies,researchers have used singing to treat respiratory function in patients with spinal cord injury.However,few studies have examined the way in which vocal training affects respiratory neural plasticity in patients with spinal cord injury.Vocal respiratory training(VRT)is a type of vocal muscle-related treatment that is often a component of music therapy(MT)and focuses on strengthening respiratory muscles and improving lung function.In this randomized controlled study,we analyzed the therapeutic effects of VRT on respiratory dysfunction at 3 months after cervical spinal cord injury.Of an initial group of 37 patients,26 completed the music therapy intervention,which comprised five 30-minute sessions per week for 12 weeks.The intervention group(n=13)received VRT training delivered by professional certified music therapists.The control group(n=13)received respiratory physical therapy delivered by professional physical therapists.Compared with the control group,we observed a substantial increase in respiratory function in the intervention group after the 12-week intervention.Further,the nerve fiber bundles in the respiratory center in the medulla exhibited a trend towards increased diversification,with an increased number,path length,thickness,and density of nerve fiber bundles.These findings provide strong evidence for the effect of music therapeutic VRT on neural plasticity.This study was approved by the Ethics Committee of China Rehabilitation Research Center(approval No.2020-013-1)on April 1,2020,and was registered with the Chinese Clinical Trial Registry(registration No.Chi CTR2000037871)on September 2,2020. 展开更多
关键词 cervical spinal cord injury music therapy neural plasticity respiratory center respiratory function vocal respiratory training
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New perspectives for investigating respiratory failure induced by cervical spinal cord injury 被引量:1
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作者 Marcel Bonay Stéphane Vinit 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第22期1949-1951,共3页
Traumatic cervical spinal cord injury (SCI), with an annual incidence of 12,000 new cases in USA (NSCISC 2013), causes devastating locomotor and respiratory paralysis and unfortunately compromises the human patien... Traumatic cervical spinal cord injury (SCI), with an annual incidence of 12,000 new cases in USA (NSCISC 2013), causes devastating locomotor and respiratory paralysis and unfortunately compromises the human patient's lifespan. The severity of the injury depends on the degree and the extent of the initial trauma. In fact, respiratory failure is the leading cause of mortality following upper cervical SCI. However, 80% of the injuries are incomplete, allowing some modest spontaneous recovery. To date, no effective treatment is available in order to restore the loss of function. 展开更多
关键词 SCI New perspectives for investigating respiratory failure induced by cervical spinal cord injury CPP
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Cervical spinal cord injury: tailoring clinical trial endpoints to reflect meaningful functional improvements
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作者 Lisa M.Bond Lisa McKerracher 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第16期1493-1497,共5页
Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extrem- ities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in... Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extrem- ities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in cervical subjects, raising the possibility of false positive outcomes in trials for cervical SCI. Endpoints focused on the recovery of hand and arm control (e.g., upper extremity motor score, motor level change) show the most potential for use as primary outcomes in upcoming trials of cervical SCI. As the field moves forward, the most reliable way to ensure meaningful clinical testing in cervical subjects may be the development of a composite primary endpoint that measures both neurological recovery and functional improvement. 展开更多
关键词 spinal cord injury SCI cervical clinical trial ENDPOINT Cethrin UEMS
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Effect of platelet activating factor on blood spinal cord barrier following cervical cord injury
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作者 肖建如 袁中平 +2 位作者 候铁胜 贾连顺 赵定麟 《Journal of Medical Colleges of PLA(China)》 CAS 1997年第1期35-38,共4页
Effect of platelet activating factor(PAF) on blood spinal cord barrier in cervical cord injury was investigated. Methods: Spinal cord injury at C6 segment was induced with Allen’s ’method in cats. PAF and PAF recept... Effect of platelet activating factor(PAF) on blood spinal cord barrier in cervical cord injury was investigated. Methods: Spinal cord injury at C6 segment was induced with Allen’s ’method in cats. PAF and PAF receptor antagonist BN52021 were administered by arachnoid space and intravenous injection respectively, and their effects on PAF levels, blood spinal cord barrier and cervical cord edema in the injuried zone and adjacent cervical cord tissue following cervical cord injury were investigated. Results: PAF levels, Evens content and water content in the injuried and adjacent cervical cord tissues significantly increased following trauma. PAF levels, Evens content and water content were evidently elevated with PAF by arachnoid space injection. PAF receptor antagonist BN52021 could inhibit the increase in PAF levels and reduce Evens and water content in the cervical cord tissue following trauma. Conclusion: PAF is an important contributing factor causing post-traumatic damage to the blood spinal cord barrier, while PAF receptor antagonist can effectively relieve post-traumatic damage to the blood spinal cord barrier. 展开更多
关键词 platelet activating factor cervical cord injury BLOOD spinal cord BARRIER
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Cervical Spine Cord Injury Associated with Klippel-Feil Syndrome: A Case Report 被引量:1
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作者 Roger Mulumba Ilunga Mohameth Faye +2 位作者 Abdoulaye Diop Nicaise Akodjetin Mahougnon Sodjinou Vital Nacoulma 《Open Journal of Orthopedics》 2021年第4期138-145,共8页
<strong>Background:</strong> Klippel Feil syndrome (KFS) is a congenital malformation characterised by the presence of, at least, one fused cervical segment and results from faulty segmentation along the e... <strong>Background:</strong> Klippel Feil syndrome (KFS) is a congenital malformation characterised by the presence of, at least, one fused cervical segment and results from faulty segmentation along the embryo’s developing axis during weeks 3 - 8 of gestation. The KFS increases the risk for spinal cord injury after minor trauma as a result of the disturbance of the biomechanics of the cervical spine. Persons with KFS often have associated congenital anomalies. <strong>Aim:</strong> The purpose of this study was to show the surgical management difficulties of this pathology in a low income country such as Senegal and to make a review of the literature. <strong>Case presentation:</strong> A 32-year-old man developed a tetraparesis secondary to a fall from his height while carrying a bag of rice on his head. Radiological explorations revealed fusedC2-C3 and C4-C5 vertebral bodies with a C3-C4 disc herniation associated to a spine contusion. The patient underwent surgical removal of the herniated disc via an anterior approach followed by interbody fusion and anterior plating. A complete recovery was noted at 4 months follow-up. <strong>Conclusion:</strong> Understanding of the cervical spine biomechanics of Klippel-Feil anomaly may allow an optimal management of patients. Patients with KFS should be warned of the increased risk of spinal cord injury after a low velocity trauma. Timing for surgery should be shortened. 展开更多
关键词 Klippel-Feil spinal cord injury cervical Disc Herniation
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Compression analysis of the gray and white matter of the spinal cord 被引量:1
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作者 Norihiro Nishida Fei Jiang +7 位作者 Junji Ohgi Akihiro Tanaka Yasuaki Imajo Hidenori Suzuki Masahiro Funaba Takashi Sakai Itsuo Sakuramoto Xian Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第7期1344-1349,共6页
The spinal cord is composed of gray matter and white matter.It is well known that the properties of these two tissues differ considerably.Spinal diseases often present with symptoms that are caused by spinal cord comp... The spinal cord is composed of gray matter and white matter.It is well known that the properties of these two tissues differ considerably.Spinal diseases often present with symptoms that are caused by spinal cord compression.Understanding the mechanical properties of gray and white matter would allow us to gain a deep understanding of the injuries caused to the spinal cord and provide information on the pathological changes to these distinct tissues in several disorders.Previous studies have reported on the physical properties of gray and white matter,however,these were focused on longitudinal tension tests.Little is known about the differences between gray and white matter in terms of their response to compression.We therefore performed mechanical compression test of the gray and white matter of spinal cords harvested from cows and analyzed the differences between them in response to compression.We conducted compression testing of gray matter and white matter to detect possible differences in the collapse rate.We found that increased compression(especially more than 50%compression)resulted in more severe injuries to both the gray and white matter.The present results on the mechanical differences between gray and white matter in response to compression will be useful when interpreting findings from medical imaging in patients with spinal conditions. 展开更多
关键词 biomechanical study cervical spondylotic myelopathy collapse rate compression gray matter mechanical properties spinal cord injury white matter
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A novel mouse model of central cord syndrome
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作者 Elzat Elham-Yilizati Yilihamu Xiangchuang Fan +1 位作者 Zimeng Yang Shiqing Feng 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第12期2751-2756,共6页
Patients with potential spinal stenosis are susceptible to central cord syndrome induced by blunt trauma.Suitable animal models are helpful for studying the pathogenesis and treatment of such injuries.In this study,we... Patients with potential spinal stenosis are susceptible to central cord syndrome induced by blunt trauma.Suitable animal models are helpful for studying the pathogenesis and treatment of such injuries.In this study,we established a mouse model of acute blunt traumatic spinal cord injury by compressing the C6 spinal cord with 5 and 10 g/mm~2 compression weights to simulate cervical central cord syndrome.Behavioral testing confirmed that this model exhibited the characteristics of central cord syndrome because motor function in the front paws was impaired,whereas basic motor and sensory functions of the lower extremities were retained.Hematoxylin-eosin staining showed that the diseased region of the spinal cord in this mouse model was restricted to the gray matter of the central cord,whereas the white matter was rarely affected.Magnetic resonance imaging showed a hypointense signal in the lesion after mild and severe injury.In addition,immunofluorescence staining showed that the degree of nerve tract injury in the spinal cord white matter was mild,and that there was a chronic inflammation reaction.These findings suggest that this mouse model of central cord syndrome can be used as a model for preclinical research,and that gray matter is most vulnerable to injury in central cord syndrome,leading to impaired motor function. 展开更多
关键词 animal model BEHAVIOR central cord syndrome cervical spinal cord injury cervical spinal cord PATHOLOGY preclinical research spinal cord spinal cord compression spinal cord injury
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创伤性颈脊髓损伤患者华勒氏变性的磁共振成像研究
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作者 袁媛 周红俊 +9 位作者 卫波 丛欣莹 刘根林 郑樱 郝春霞 张缨 王一吉 康海琼 逯晓蕾 蒙倩茹 《中国康复理论与实践》 CSCD 北大核心 2024年第4期487-492,共6页
目的探讨创伤性颈脊髓损伤患者脊髓华勒氏变性(WD)的磁共振成像(MRI)信号特点。方法回顾性分析2015年1月至2021年12月在北京博爱医院脊髓损伤康复科住院康复的191例创伤性颈脊髓损伤患者的临床资料,对常规颈椎MRI的矢状位及轴位T2加权像... 目的探讨创伤性颈脊髓损伤患者脊髓华勒氏变性(WD)的磁共振成像(MRI)信号特点。方法回顾性分析2015年1月至2021年12月在北京博爱医院脊髓损伤康复科住院康复的191例创伤性颈脊髓损伤患者的临床资料,对常规颈椎MRI的矢状位及轴位T2加权像(T2WI)进行影像学评估,将其分为WD组和非WD组。比较两组性别、年龄、损伤机制、美国脊柱损伤协会残损分级(AIS)、神经平面、伤后获得MRI的时间差等,并分析WD在脊髓的背柱区(DC)、外侧脊髓丘脑束区(ST)和外侧皮质脊髓束区(CS)的信号特点。结果115例(60.2%)出现WD。WD组与非WD组年龄、损伤机制、AIS的等级分布和伤后获得MRI时间差有显著性差异(Z>3.820,χ2>9.104,P<0.05)。WD组中,在损伤部位的上方,DC、ST的WD发生率分别为100%和87%;在损伤部位的下方,CS的WD发生率为35.7%。根据WD信号出现的方式将其分为3组,只出现DC变化的15例(13%),DC合并ST发生变化为59例(51.3%),DC、ST、CS 3个位置均有变化的41例(35.7%)。3组间伤后获得MRI的时间差有显著性差异(H=90.794,P<0.05),3组间AIS等级分布无显著性差异(P>0.05)。结论创伤性颈脊髓损伤患者的常规MRI检查T2WI可检测到WD信号,且WD的发生与伤后时间存在关联。 展开更多
关键词 创伤性颈脊髓损伤 华勒氏变性 磁共振成像 美国脊柱损伤协会残损分级
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颈椎后路椎管扩大椎板成形术联合单侧椎弓根螺钉短节段内固定术治疗MRI T2WI高信号无骨折脱位型颈椎脊髓损伤
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作者 曹勇 李信 +2 位作者 顾红林 陈志刚 吕书军 《脊柱外科杂志》 2024年第2期117-122,共6页
目的 比较颈椎后路椎管扩大椎板成形术联合单侧椎弓根螺钉短节段内固定术与颈椎前路减压植骨融合内固定术治疗MRI T2WI高信号无骨折脱位型颈椎脊髓损伤(SCI)的临床疗效。方法 2014年1月-2017年1月海安市人民医院收治MRI T2WI高信号无骨... 目的 比较颈椎后路椎管扩大椎板成形术联合单侧椎弓根螺钉短节段内固定术与颈椎前路减压植骨融合内固定术治疗MRI T2WI高信号无骨折脱位型颈椎脊髓损伤(SCI)的临床疗效。方法 2014年1月-2017年1月海安市人民医院收治MRI T2WI高信号无骨折脱位颈椎SCI患者89例,其中43例采用颈椎后路椎管扩大椎板成形术联合单侧椎弓根螺钉短节段内固定术治疗(后路组),46例采用颈椎前路减压植骨融合内固定术治疗(前路组)。记录2组手术时间、术中出血量,手术前后颈椎活动度(ROM)、脊髓横截面积、椎管面积残余率、髓内高信号强度比值,手术前后采用日本骨科学会(JOA)评分和颈椎功能障碍指数(NDI)评价疗效。结果 所有手术顺利完成,所有患者随访时间> 24个月。2组手术时间、术中出血量差异无统计学意义(P> 0.05)。末次随访时,2组脊髓横截面积、椎管面积残余率、髓内高信号强度比值、JOA评分和NDI较术前显著改善,且后路组颈椎ROM、椎管面积残余率、NDI和NDI改善率优于前路组,差异均有统计学意义(P <0.05)。结论 2种术式均可有效治疗MRI T2WI高信号无骨折脱位型颈椎SCI,但颈椎后路椎管扩大椎板成形术联合单侧椎弓根螺钉短节段内固定术在术后远期生活质量改善方面更胜一筹,同时可更好地保留颈椎ROM。 展开更多
关键词 颈椎 脊髓损伤 减压术 外科 脊柱融合术 内固定器
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创伤性颈脊髓损伤患者住院期间并发肺部感染的风险因素分析
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作者 冯爱星 冯爱云 梁明哲 《颈腰痛杂志》 2024年第1期112-115,共4页
目的观察创伤性颈脊髓损伤(traumatic cervical spinal cord injury,TCSCI)患者住院期间的肺部感染发生情况,并分析其潜在的风险因素。方法回顾性分析我院2018年3月~2022年3月收治的110例TCSCI患者临床资料,根据住院期间是否并发肺部感... 目的观察创伤性颈脊髓损伤(traumatic cervical spinal cord injury,TCSCI)患者住院期间的肺部感染发生情况,并分析其潜在的风险因素。方法回顾性分析我院2018年3月~2022年3月收治的110例TCSCI患者临床资料,根据住院期间是否并发肺部感染,分为感染组和非感染组。统计两组患者的潜在相关资料,并进行组间单因素分析和多因素Logistic回归分析。结果110例中,41例(37.3%)住院期间发生肺部感染,发生于入院后的3~10 d、平均4.3 d;其中,35例(85.4%)经积极治疗后好转,6例(14.6%)最终因并发呼吸衰竭死亡。多因素Logistic回归模型分析证实:呼吸机辅助通气(OR=6.498,P<0.001)、血清Na+水平(OR=0.693,P=0.001)和ASIA分级(OR=0.386,P<0.001)均是TCSCI患者住院期间并发肺部感染的独立影响因素。结论TCSCI患者住院期间肺部感染的发生率较高,呼吸机辅助通气可增加肺部感染的风险;而ASIA分级较高、血清Na+水平趋于正常者,其并发肺部感染的风险相对较低。 展开更多
关键词 颈脊髓损伤 颈椎创伤 肺部感染 呼吸机辅助通气 低钠血症
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无骨折脱位型颈脊髓损伤的病理机制与治疗进展
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作者 段韩磊(综述) 强京灵(审校) 《中国临床神经外科杂志》 2024年第1期49-53,共5页
无骨折脱位型颈脊髓损伤(CSCIWFD)是一种特殊类型的脊髓损伤,在临床中并不少见。病人虽然具有颈脊髓损伤的临床症状,但X线、CT检查却没有骨折脱位等影像学表现,很容易被临床医生误诊,从而影响后续诊疗。本文就CSCIWFD的损伤机制、临床... 无骨折脱位型颈脊髓损伤(CSCIWFD)是一种特殊类型的脊髓损伤,在临床中并不少见。病人虽然具有颈脊髓损伤的临床症状,但X线、CT检查却没有骨折脱位等影像学表现,很容易被临床医生误诊,从而影响后续诊疗。本文就CSCIWFD的损伤机制、临床表现、病理生理特点、分型及目前治疗进展进行综述,为临床提供参考,以使CSCIWFD病人可以得到早期准确的诊断,降低漏诊率,早期得到有效的治疗,改善病人的预后。 展开更多
关键词 脊髓损伤 无骨折脱位型颈脊髓损伤 发病机制 治疗进展
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创伤性颈脊髓损伤患者低钠血症的发生率及相关因素
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作者 罗梅梅 裴国清 +2 位作者 黑秀秀 张亚玲 牟芷惠 《颈腰痛杂志》 2024年第1期79-82,共4页
目的探讨本地区创伤性颈脊髓损伤(traumatic cervical spinal cord injury,TCSCI)患者低钠血症的发生率及影响因素。方法选择2019年1月~2021年12月在该院就诊的TCSCI患者资料进行回顾性分析,记录患者的年龄、性别、损伤原因、严重程度(... 目的探讨本地区创伤性颈脊髓损伤(traumatic cervical spinal cord injury,TCSCI)患者低钠血症的发生率及影响因素。方法选择2019年1月~2021年12月在该院就诊的TCSCI患者资料进行回顾性分析,记录患者的年龄、性别、损伤原因、严重程度(完全或不完全性脊髓损伤)和脊髓损伤水平、血清钠水平、治疗策略及低钠血症持续天数,观察是否低钠血症患者的临床资料差异。结果共有54例发生低钠血症,发生率为58.06%。单因素分析显示,低钠血症和非低钠血症患者性别、损伤原因、白蛋白水平差异均无统计学意义(P>0.05);两组患者年龄、损伤平面、ASIA分级、甲强龙冲击、神经源性休克、体温、合并感染、每日尿量等差异存在统计学意义(P<0.05)。多因素Logistic回归分析显示,完全性脊髓损伤和神经源性休克是TCSCI患者发生低钠血症的风险因素(P<0.05)。结论TCSCI后低钠血症发生率为58.06%,完全性脊髓损伤和神经源性休克是TCSCI患者发生低钠血症的风险因素,临床应早期监测TCSCI发生后的钠离子水平,以早发现、早期干预治疗。 展开更多
关键词 创伤性颈脊髓损伤 低钠血症 影响因素 神经源性休克
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急性颈脊髓损伤围手术期临床护理常见问题专家共识
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作者 中国康复医学会脊柱脊髓护理学组 李云 +5 位作者 尹会 卢丹 张瑞雪 栗晓静 徐欣欣 郭立杰 《中国医药指南》 2024年第12期1-7,共7页
为规范急性颈脊髓损伤患者救治过程中的护理操作,指导临床实践,促进临床对急性颈脊髓损伤患者的规范化护理。通过查阅国内外文献,拟定临床急性颈脊髓损伤救治过程中的护理常见问题专家共识初稿,结合专家意见修改相应条目,评定证据等级... 为规范急性颈脊髓损伤患者救治过程中的护理操作,指导临床实践,促进临床对急性颈脊髓损伤患者的规范化护理。通过查阅国内外文献,拟定临床急性颈脊髓损伤救治过程中的护理常见问题专家共识初稿,结合专家意见修改相应条目,评定证据等级和推荐等级,形成共识终稿。本共识总结了急性颈脊髓损伤患者的院前急救、病史采集与评估、病情监测与观察、用药指导,颈部固定、呼吸道护理、消化道护理、泌尿系护理、皮肤护理、疼痛护理、体位护理、心理护理、功能锻炼等方面的最新证据,内容覆盖救治过程中的各个关键环节。共识条目简单明了,易于执行,能够为临床护理实践提供指引,有助于解决临床问题,但仍需要进一步的理论和实证研究验证。 展开更多
关键词 急性颈脊髓损伤 院前急救 围手术期 并发症 康复 护理 专家共识
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急性颈脊髓损伤髓内出血水肿患者术后神经功能恢复的风险因素分析
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作者 段伟利 王淼 陈双辉 《颈腰痛杂志》 2024年第2期258-262,267,共6页
目的观察伴髓内出血水肿的急性颈脊髓损伤(cervical spinal cord injury,CSCI)患者的手术减压效果,并分析术后神经功能恢复不良的预测因素。方法回顾性分析该院于2018年3月~2022年3月收治的71例伴髓内出血水肿的急性CSCI患者资料,测量... 目的观察伴髓内出血水肿的急性颈脊髓损伤(cervical spinal cord injury,CSCI)患者的手术减压效果,并分析术后神经功能恢复不良的预测因素。方法回顾性分析该院于2018年3月~2022年3月收治的71例伴髓内出血水肿的急性CSCI患者资料,测量其术前MRI所示的髓内出血信号长度(intramedullary hemorrhage length,IHL)、髓内水肿信号长度(intramedullary edema length,IEL)、脊髓受压指数(maximum spinal cord compression,MSCC)等指标。于术前、术后3 d时,评价其ASIA运动评分(the ASIA motor score,AMS),并计算其AMS恢复率;术后6个月,以AIS分级改善≥1级判定为术后神经功能恢复(改善组),以AIS分级未改善甚至加重判定为术后神经功能未恢复(未改善组)。比较两组患者的相关资料,并采用多元Logistic回归分析得出CSCI患者术后神经功能恢复不良的预测因素。结果术后6个月,有54例(76.1%)患者的神经功能AIS分级改善了1级或以上,17例(23.9%)的AIS分级未见改善。两组患者的性别、年龄、创伤原因、伤后就诊时间、受伤至手术时间、术前AIS分级、软组织损伤情况和手术入路、术后康复训练情况等资料的差异均无统计学意义(P>0.05)。未改善组患者的术前IHL、IEL和MSCC指数显著高于改善组(P<0.05),损伤节段数显著多于改善组(P<0.05)。两组患者术前AMS评分无显著差异(P>0.05),但未改善组患者术后3 d的AMS评分和AMS改善率均显著低于改善组(P<0.05)。多元Logistic回归分析显示:术后3 d的AMS评分恢复率(OR=0.752,P=0.040)和术前IHL(OR=1.805,P=0.032)均是CSCA患者术后6个月神经功能恢复不良的独立预测因素。结论伴髓内出血水肿的CSCA患者脊髓损伤较重,术前MRI所见的IHL信号越长、术后3 d的AMS评分恢复率越低,则预示着患者术后远期神经功能恢复不良的风险越高。 展开更多
关键词 急性颈脊髓损伤 髓内出血水肿 MRI检查 T2加权像 AIS分级 预后不良
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急性创伤性颈脊髓损伤术后继发神经源性休克危险因素及预测效能分析
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作者 朱晓凤 尉国莲 +2 位作者 姚丹华 金叶霞 盛娇娇 《浙江创伤外科》 2024年第4期603-605,609,共4页
目的 探讨急性创伤性颈脊髓损伤术后继发神经源性休克危险因素并进一步分析相关因素临床预测效能。方法 回顾性纳入2021年6月至2023年6月于本院行手术治疗急性创伤性颈脊髓损伤患者共100例,根据术后是否继发神经源性休克分为休克组(39例... 目的 探讨急性创伤性颈脊髓损伤术后继发神经源性休克危险因素并进一步分析相关因素临床预测效能。方法 回顾性纳入2021年6月至2023年6月于本院行手术治疗急性创伤性颈脊髓损伤患者共100例,根据术后是否继发神经源性休克分为休克组(39例)和非休克组(61例);采用单因素和多因素法评估急性创伤性颈脊髓损伤术后继发神经源性休克独立危险因素;描绘ROC曲线分析上述独立危险因素用于急性创伤性颈脊髓损伤术后继发神经源性休克风险预测临床效能。结果 本研究纳入于本院行手术治疗急性创伤性颈脊髓损伤患者共100例,术后继发神经源性休克39例,发生率为39.00%;单因素分析结果显示,是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量均可能与急性创伤性颈脊髓损伤术后继发神经源性休克有关(P<0.05);多因素分析结果显示,低钠血症、美国脊髓损伤协会损伤分级A级及24 h尿量增多均是急性创伤性颈脊髓损伤术后继发神经源性休克独立危险因素(P<0.05);ROC曲线分析结果显示,是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量均可用于急性创伤性颈脊髓损伤术后继发神经源性休克风险预测,且三种指标联合预测效能均显著高于单一指标(P<0.05)。结论 急性创伤性颈脊髓损伤术后继发神经源性休克与是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量关系密切;而上述指标联合在预测术后继发神经源性休克风险方面显示出更佳效能。 展开更多
关键词 急性创伤性颈脊髓损伤 手术 神经源性休克 危险因素
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改良气道护理在颈脊髓损伤预防呼吸道并发症中的应用
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作者 胡梅娇 《赣南医学院学报》 2024年第2期174-176,共3页
目的:探讨改良气道护理在颈脊髓损伤患者中预防呼吸道并发症的疗效。方法:选取2019年1月至2022年1月脊柱外科救治的30例颈脊髓损伤患者,按入院时间分为2组,对照组14例,试验组16例。对照组采用常规护理方法,试验组采用改良气道护理方法,... 目的:探讨改良气道护理在颈脊髓损伤患者中预防呼吸道并发症的疗效。方法:选取2019年1月至2022年1月脊柱外科救治的30例颈脊髓损伤患者,按入院时间分为2组,对照组14例,试验组16例。对照组采用常规护理方法,试验组采用改良气道护理方法,比较2组患者肺活量(Vital capacity,VC)和呼吸道并发症发生情况。结果:治疗前2组VC差异无统计学意义(P>0.05),治疗后试验组VC[(61.13±3.81)%]较对照组[(51.73±2.47)%]大,差异有统计学意义(P<0.05)。试验组出现1例腹部感染、1例肺不张,对照组出现3例肺部感染、4例肺不张,2组并发症发生率比较差异有统计学意义(P<0.05)。结论:改良气道护理在颈脊髓损伤患者预防呼吸道并发症改善呼吸功能方面有较好的疗效。 展开更多
关键词 气道护理 颈脊髓损伤 呼吸道 并发症
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