无骨折脱位型颈髓损伤延迟期不同治疗方案的疗效观察.PDFVIP

中国现代医生 2019年7月第57卷第 19期 窑论 著 窑 无骨折脱位型颈髓损伤延迟期不同治疗方案的 疗效观察 张正超员袁圆 张旭鸣员袁圆 何武兵员袁圆 齐建超员袁圆 郭立成员袁圆银 1.福建省立医院急诊外科袁福建福州 350001曰2.福建医科大学省立临床医学院袁福建福州 350001 [摘要] 目的探讨无骨折脱位型颈髓损伤延迟期保守治疗及不同后路手术治疗方案的治疗效果遥 方法 回顾分 析2013年 1月耀2017年 10月70例无骨折脱位型颈髓损伤延迟期就诊患者袁其中采用颈后路全椎板减压侧块螺 钉固定23例袁采用颈后路单开门减压钛板固定23例袁采用保守治疗24例遥根据日本JOA脊髓功能评分袁观察三 种方法治疗后JOA评分改善率情况遥 结果本次70例随访患者袁均随访 1年袁随访JOA改善率袁3个月保守治疗 组和两组后路手术组差异有统计学意义渊P0.05冤遥 单开门减压钛板固定组与全椎板切除减压侧块螺钉内固定组 间差异无统计学意义渊P0.05冤遥 12个月保守治疗组和两组后路手术组差异有统计学意义渊P0.05冤遥 单开门减压 钛板固定组与全椎板切除减压侧块螺钉内固定组间差异无统计学意义渊P0.05冤遥 结论对于无骨折脱位型颈髓 损伤延迟期患者袁手术治疗效果优于保守治疗袁不同后路手术方式预后无明显差异遥 [关键词] 无骨折脱位型颈髓损伤曰延迟期曰治疗方案曰JOA 评分改善率 [中图分类号] R657.2 [文献标识码] A [文章编号] 1673-9701渊2019冤19-0031-05 Therapeutic effect of different treatment regimens on cervical spinal cord injury withoutfracture anddislocationin delayedperiod 1,2 1,2 1,2 1,2 1,2银 ZHANG Zhengchao ZHANG Xuming HE Wubing QIJianchao GUOLicheng 1.Departmentof Emergency Surgery袁Fujian Provincial Hospital袁Fuzhou 350001袁China曰2.Provincial Clinical Medical College袁Fujian MedicalUniversity袁Fuzhou 350001袁China [Abstract] Objective To investigate the therapeutic effect of conservative treatment and different posterior approach surgical treatment regimens on cervical spinal cord injury without fracture and dislocation in delayed period. Methods 70 patients with cervical spinal cord injury without fracture and dislocation in delayed period from January 2013 to October 2017 were retrospectively analyzed. Among them, 23 patients were treated with posterior cervical laminectomy andlateral block screwfixation, 23 patients were treated