急诊早期甲泼尼龙冲击对无骨折脱位型颈脊髓损伤后期脊髓功能恢复的影响

摘要

ObjectiveTo investigate the effect of using high-dose methylprednisolone (mP) early on functional recovery of patients after cervical spinal cord injury without fracture and dislocation(csciWfd).Method from december 2009 to september 2013, 30 patients were enrolled in this study.The patients were assigned to 2 groups: 16 patients constituting group a were applied high does of methylprednisolone combined with anterior decompression operation, while 14 patients who can not be applied methylprednisolone due to various reasons constitute group B and underwent the anterior decompression operation only. The Joa score and improvement rate of spine function in the two groups at the time of admission and 3 weeks after operation were compared.Result comparing Joa scores on admission and 3 weeks as well as 6 months after operation, the Joa score and improvement rate of the spinal cord function 6 months after operation in group a was found better than that in group B 6 month. Conclusion csciWfd,as a special type of cervical spinal cord injury,should be diagnosed as soon as possible according to the physical examination before X-ray and cT showed fracture or dislocation. When this injury was diagnosed, high doses of mP should be applied according to nascisⅢrole in order to obtain the best recovery of spinal cord function in the patients.%目的：探讨早期应用甲泼尼龙冲击无骨折脱位型颈脊髓损伤（csciWfd）对后期脊髓功能恢复的影响。方法回顾性分析本院自2009年12月至2013年9月收治的30例csciWfd患者，分为a组：16例按nascis iii行甲泼尼龙冲击＋手术治疗，B组：14例因各种原因无法行甲泼尼龙冲击，单纯行手术治疗，比较其入院时与术后3周、6个月Joa评分及改善率。结果通过对比入院时Joa评分及术后3周、6个月时Joa评分，发现a组术后6个月Joa评分及脊髓功能改善率高于B组。结论 csciWfd作为一种特殊型颈髓损伤，根据临床经验应及早作出诊断，并开始进行甲泼尼龙冲击，以利于患者后期脊髓功能获得最佳恢复效果。