手术与非手术治疗中央型颈脊髓损伤的效果分析.doc

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1、手术与非手术治疗中央型颈脊髓损伤的效果分析［摘要］目的对比和分析手术和非手术方法治疗中央型颈脊髓损伤患者的临床效果。方法选取本院收治的367例患者分为手术组与非手术组，均在受伤6h内釆用甲泼尼龙冲击疗法、20%甘露醇脱水、营养神经治疗。非手术组在此治疗1〜2周后即可出院，手术组在此治疗方案实施2〜4d后行手术治疗。结果两组在手术、出院、随诊时的ASIA运动功能评分均高于入院前，差异有统计学意义(P<0.01)；两组在治疗12个月时的ASIA运动功能评分均显著高于入院时，差异有统计学意义(P<0.0

2、5)；手术组的恢复率为(67.3土6.8)%,非手术组的恢复率为(56.2+7.1)%,两组比较差异有统计学意义(P<0.05)；手术组中无一例出现不良反应，非手术组中有47例患者出现迟发症状，不良反应率为25.40%。结论采用手术治疗中央型颈脊髓损伤患者可以更为有效地提高临床效果及患者的生活质量，值得临床推广应用。［关键词］中央型颈脊髓损伤；颈椎；手术治疗；非手术治疗［中图分类号］R744［文献标识码］B［文章编号］1674-4721(2014)05(b)-0158-03Effectanalys

3、isofoperationandnon-operationinthetreatmentofcentralcervicalcordinjurySHIMing-huaDepartmentofOrthopaedics,JiangxiPoyanghuHospital,Poyang330025,China[Abstract]ObjectiveTocompareandanalyzeeffectanalysisofoperationandnon-operationinthetreatmentofpatients

4、withcentralcervicalcordinjury.MethodsThreehundredandsixty-sevenpatientsadmittedintoourhospitalweredividedintooperativegroupandnon-operativegroup.Al1injuredparticipantswereprovidedwithmethylprednisoloneshocktherapy,20%mannitolfordehydrationandtrophicne

5、rvetherapy.Patientsinthenon-operativegroupweredischargedfromhospitalafteroneortwoweek-treatment.Intheoperativegroup,operativetreatmentwasperformedafter2to4daysimp!ementationoftherapeuticregimen.ResultsASIAmotorscoresintheoperation,discharge,follow-upt

6、imeoftwogroupswashigherthanthatadmittedtohospitalrespectively,withstatisticaldifference(P<0.01).ASIAmotorscoresaftertreatment12monthsoftwogroupswashigherthanthatadmittedtohospitairespectively,withstatisticaldifference(卩<0.05)・Recoveryrateinoperativegr

7、oupwas(67.3±6.8)%,whilerecoveryrateinnon-operativegroupwas(56.2±7.1)%,withstatisticaldifference(PV0.05).Noadversereactionoccurredinoperativegroup,but47casespresentedwithtardinessaccountingfor25.40%innon-operativegroup.ConclusionOperativetreatmentforpa

8、tientswithcentralcervicalcordinjurycaneffectivelyimproveclinicalefficacyandqualityoflife,whichisworthyofexpansionandapplicationinclinic・[Keywords]Centralcervicalcordinjury;Cervicalvertebra;Operativetreatment;Non-operativetreatment近年来，屮央型颈脊髓损伤患