成人无骨折脱位型颈脊髓损伤不同治疗方法疗效对比分析(1)
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[摘要] 目的 探讨采用手术治疗和采用保守治疗对成人颈椎无骨折脱位型颈脊髓损伤的效果及其与神经功能变化之间的关系。 方法 75例成人颈椎无骨折脱位型脊髓损伤患者分为三组，分组以采取不同的治疗措施为依据，采用ASIA标准运动，感觉评分及其残损分级对所有的研究对象进行评定。 结果 与入院时的运动评分比较，各组的末次随访时的评分均有显著增加(P < 0.01)。两手术组的运动评分及其针刺觉评分在入院和末次随访时均明显低于保守治疗组(P < 0.05)。 结论 临床上对于成人颈椎无骨折脱位型脊髓损伤患者无论采用手术治疗方法还是采用保守治疗方法在改善神经功能程度上均为有限，而对预后起决定作用则是外伤时脊髓损害的程度。
[关键词] 手术治疗；保守治疗；成人颈椎无骨折脱位型脊髓损伤；神经功能
[中图分类号] R651.2 [文献标识码] B [文章编号] 1673-9701(2012)03-0059-02
Adults without fracture or dislocation of cervical spinal cord injury therapy effectiveness analysis of different
ZHANG Bingchen
Department of Orthopedics, Heibei Province Shijiazhuang Luquan City People's Hospital, Luquan 050200, China
[Abstract] Objective To explore the effect and changes in relationships of surgery and conservative treatment for adult cervical spinal cord injury without fracture or dislocation and neurological. Methods All of 75 cases of adult cervical spinal cord injury without fracture or dislocation were divided into three groups, ASIA standard classification of motor, sensory scores and damaging the object of study for all levels to score. Results Compared with the score of admission，the score of each group on the last follow-up were significantly increased(P < 0.01). Sports scores and pinprick scores of two surgical groups on admission and last follow-up were significantly lower than those of the conservative group (P < 0.05). Conclusion For adult cervical spinal cord injury without fracture or dislocation regardless of surgical treatment or conservative treatment for patients with neurological their degree of improvement are limited. Play a decisive role for the prognosis is the extent of the damage spinal cord trauma.
[Key words] Surgery; Conservative treatment; Adult cervical spinal cord injury without fracture or dislocation; Neurological function
近年来，成人颈椎无骨折脱位型脊髓损伤(SCIWO-RA)的治疗受到医务工作者的广泛关注[1]。笔者收集来我院进行治疗的75例成人颈椎无骨折脱位型脊髓损伤患者，将其分为前路手术组，后路手术组，保守治疗组，并对三组的治疗效果进行比较分析，现报道如下。
1 资料与方法
1.1 临床资料
收集2006～2011年来我院进行治疗的75例成人颈椎无骨折脱位型脊髓损伤患者，其中男68例，女7例，最小年龄32岁，最大年龄71岁，平均(53.9±13.5)岁，随访时间最短为47周，最长为62周，平均随访时间(55.7±11.2)周，将所有的研究对象分为三组，分组以采取不同的治疗措施为依据，分别为前路手术组32例，后路手术组36例，保守治疗组7例。
1.2 方法
7例患者采用保守治疗(保守治疗组)，68例患者采用手术的方法进行治疗，手术均在患者受伤后的7 d内完成手术。前路手术组32例，后路手术组36例 ......
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