摘要
目的提高对急性横贯性脊髓炎（ATM）的病因、临床特征、诊断和治疗的认识。方法建立ATM的诊断标准,对我院1992~2009年间收治的117例住院病人的临床资料进行回顾性分析。结果 117例ATM患者中发病高峰年龄为11-50岁,占全部病例的86.1%;11-20岁年龄段发病率最高,达26.9%。夏秋两季ATM发病人数占全部病例的68%;从城乡差别来看,农村病人占71.2%。ATM患者瘫痪的高峰时间分别为5.86 d和11.21 d。42例患者采用甲基强的松龙短程冲击治疗,23例患者采用免疫球蛋白治疗,52例患者采用常规剂量皮质类固醇激素及B族维生素和神经营养药等综合治疗。3组患者的治愈率分别为45%、48%和44%;好转率为37%、33%、39%;无效率为18%、19%和17%。结论尽管ATM是一种散发性、少见的神经系统性疾病,但在发病年龄、季节、城乡区域等方面有一定的流行病学特点,临床症状取决于受累脊髓的阶段和病变范围,皮质激素疗法仍是一种有效的治疗手段。
Objective To elevate the more understanding of pathogenesis,characteristics of clinical symptoms,diagnosis and treatment of acute transverse myelitis（ATM）.Methods The clinical data of 117 ATM hospitalized patients were retrospectively analyzed from 1992 to 2009 according to the diagnostic standards of ATM.Results There was an apparent peak in the age group 11～50 years（86.1%）based on all hospitalized patients.If the incidence rate was counted on each 10 years,it was higher between 11 and 20 years of age.There was obvious seasonal variation,e.g.summer and autumn,but no annual fluctuation in frequency.Some 71.2%of the patients came from the rural district.All patients had paraplegia or quadriplegia on varying degrees,peak time were 5.86 and 11.21 days respectiuely.All patients were divided into intravenous methylprednisolone group（42 cases）,intravenous immunoglobulin group（23 cases） and complex treatments group（52 cases）.The respective curative effect rate of three groups was 45%,48% and 44%.The respective resolving rate was 37%,33% and 39%.The ineffective rate of treatment was 18%,19% and 17% separately.Conclusion Even though ATM is a rare and disseminated neurological disease,it has some epidemiological characteristics on age of onset,season,and district.The clinical manifestations are determined by the spinal segment involved and lesion range.The complex treatments should be taken mainly with glucocorticoid to gain the best curative effect rate and resolving rate.
出处
《中国实用神经疾病杂志》
2011年第11期1-4,共4页
Chinese Journal of Practical Nervous Diseases
