摘要
目的:探讨老龄颈脊髓损伤患者的临床特点,总结老龄颈脊髓损伤治疗原则及治疗方法。方法:自2006年7月至2011年10月收治的65岁以上颈脊髓损伤患者作为老龄组,共27例,男20例,女7例;年龄65～78岁,平均69岁。选取同期65岁以下颈脊髓损伤患者作为对照组,以脊髓损伤程度作为参考标准选择与老龄组脊髓损伤程度近似的病例作为对照组,共22例,男16例,女6例;年龄38～65岁,平均47岁。所有患者有明确外伤史,且于伤后1周内入院。对两组患者的临床特点及随访结果进行分析。分析两组患者的合并症、住院期间并发症发生率及病死率,并采用Frankel分级标准对患者入院及伤后1年的神经功能进行评定。结果:除死亡病例外,所有患者获得1年以上的随访。老龄组23例存在合并症,24例住院期间发生并发症,其中3例于住院期间因并发症而死亡,3例出院后死亡。老龄组合并症、并发症发生率及病死率与对照组相比,差异有统计学意义(P<0.05)。伤后1年随访时老年组有2例神经功能恢复至Frankel分级E级,而对照组6例。结论:老龄颈脊髓损伤患者合并症多,并发症发生率高,病死率高,神经功能恢复差。治疗以手术治疗为主,但应尽量简化手术方式,以有效减压和稳定性重建为主要目的,避免手术扩大化,并重视患者呼吸道并发症的防治。
Objective：To investigate clinical features and treatments of cervical spinal injury in aged patients. Methods： From July 2006 to October 2011,27 patients with cervical spinal cord injury were divided into experiment group,including 20 males and 7 females with an average age of 69 years old （ranged 65 to 78 years old）. The other 22 patients with the same degree of cervical spianl cord injury and the same period hospitalization were chosen to regard as control group ,including 16 males and 6 females with an average age of 47 years old （ranged 38 to 65 years old）. All of them had clear history of trauma, and were admitted to hospital within one week. Clinical data and result of follow up were evaluated between two group. The function of the spinal cord was measured by Frankel classification at admission and final follow up. Results：All patients were followed up for 1 year except 6 died in aged group,among which 3 paients with complications were died during hospitalization and others were out of hospital. Twenty three cases had accompanied diseases and 24 cases occurred complications in aged group. Contrast to control group,this difference was statistically significant. At the final follow up,there were 2 cases at Frankel grade E in aged group and 6 cases in control group. Conclusion：In comparison with control group,there are more accompany diseases and higher complications and mortality rates in aged group,while poor improvement of spinal cord function. This patients were mainly treated with operation,but operation method should simplify and mainly focus on effective decompression and reconstuction stability and avoid expansion operation. It＇s nesscerry to pay more attention to prevent and treatment of res-piratory complication.
出处
《中国骨伤》
CAS
2013年第8期663-667,共5页
China Journal of Orthopaedics and Traumatology
关键词
老年人
颈椎
脊髓损伤
治疗
Aged
Cervical vertebrae
Spinal cord injuries
Therapy
