Nwadinigwe C U, Iloabuchi T C, Nwabude I A
National Orthopaedic Hospital Enugu, Nigeria.
Niger J Med. 2004 Apr-Jun;13(2):161-5.
Management of spinal cord injured patients is an integral part of trauma care. There is need to congregate these patients in spinal units where dedicated experts and facilities exist for better outcome of treatment and rehabilitation. The objective of this study therefore, is to promote improved quality of care in the group of patients by highlighting the deficiencies in our setting.
This is a retrospective study of all traumatic spinal cord injured (SCI) seen at the National Orthopaedic Hospital, Enugu over a six-year period. Information about the demographics, aetiology, level of injury, associated injuries, time of presentation, referral hospital, state of injury, duration of hospitalization, outcome of treatment were obtained from patients' records. Data were analyzed using commercially available SPSS for windows 9. Descriptive statistics are given.
There were 104 patients, 88 males and 16 females, giving a ratio of 5.5:1. Road traffic accident, 60 (57.7%), was the commonest aetiological factor and the cervical spine, 70 (67.3%), was most often involved. Head and neck injuries were common associated injuries, 19 (18.3%) in patients with cervical spine injury. Six (5.8%) of our patients were obtunded. Most patients, 69 (66.4%), were received from private hospitals after a mean duration of 7 days. Hospitalization ranged from 1 week-120 weeks with a mean of 11 weeks. Pressure sore was the commonest complication, 30 (28.8%). Thirty six (34.4%) of patients died mainly from respiratory failure. Most of the discharged wheel bound patients (97%) were lost to follow up.
For better outcome we re-emphasize the need to establish and congregate these patients into regional spinal units. We also suggest a social legislation, which will be fundamental to social re-integration of these SCI and other severely disabled patients.
脊髓损伤患者的管理是创伤护理的重要组成部分。有必要将这些患者集中在设有专业专家和设施的脊髓治疗单元,以获得更好的治疗和康复效果。因此,本研究的目的是通过突出我们现有环境中的不足之处,促进该组患者护理质量的提高。
这是一项对在六年期间于埃努古国家骨科医院就诊的所有创伤性脊髓损伤(SCI)患者的回顾性研究。从患者记录中获取有关人口统计学、病因、损伤水平、相关损伤、就诊时间、转诊医院、损伤状态、住院时间、治疗结果等信息。使用适用于Windows 9的商用SPSS软件对数据进行分析。给出描述性统计数据。
共有104例患者,男性88例,女性16例,男女比例为5.5:1。交通事故是最常见的病因,共60例(57.7%),颈椎损伤最为常见,共70例(67.3%)。头部和颈部损伤是常见的相关损伤,在颈椎损伤患者中有19例(18.3%)。6例(5.8%)患者昏迷。大多数患者,共69例(66.4%),在平均7天后从私立医院转诊而来。住院时间为1周 - 120周,平均为11周。压疮是最常见的并发症,共30例(28.8%)。36例(34.4%)患者死亡,主要死于呼吸衰竭。大多数出院的轮椅依赖患者(97%)失访。
为了获得更好的治疗效果,我们再次强调有必要建立并将这些患者集中到区域脊髓治疗单元。我们还建议制定一项社会立法,这对于这些脊髓损伤患者和其他严重残疾患者重新融入社会至关重要。