与脊髓损伤相关的呼吸并发症。

Respiratory complications associated with spinal cord injury.

作者信息

Tollefsen Elin, Fondenes Ove

机构信息

Nasjonalt register for langtids mekanisk ventilasjon, Lungeavdelingen, Haukeland universitetssykehus.

出版信息

Tidsskr Nor Laegeforen. 2012 May 15;132(9):1111-4. doi: 10.4045/tidsskr.10.0922.

Abstract

BACKGROUND

Respiratory complications are the most common cause of acute and long-term morbidity and mortality in patients with spinal cord injury.

MATERIAL AND METHODS

The article is based on a non-systematic search in PubMed and the authors' clinical experience in treatment and follow-up of respiratory complications in patients with spinal cord injury.

RESULTS

The extent of respiratory complications is dependent on the level of spinal cord injury and the degree of motor completeness. In acute spinal cord injury, 80 % of patients may suffer from respiratory complications. Long-term follow-up indicates that respiratory complications are the most common cause of death in these patients. The most common respiratory complications are atelectasis, pneumonia and respiratory failure. Prevention of respiratory complications must be initiated immediately, independent of the level of spinal cord injury. The question of mechanical ventilation in the acute setting, and also during long-term follow-up must be addressed, along with aggressive secretion management. Patients with spinal cord injury have a high prevalence of sleep apnea that may influence their quality of life and rehabilitation.

INTERPRETATION

Respiratory complications are common in patients with spinal cord injury. These patients need a multidisciplinary approach. All disciplines involved must obtain knowledge of respiratory complications in the acute phase and in the longer term, to ensure patients are referred for necessary pulmonary review and follow-up.

摘要

背景

呼吸并发症是脊髓损伤患者急性和长期发病及死亡的最常见原因。

材料与方法

本文基于在PubMed上的非系统检索以及作者在脊髓损伤患者呼吸并发症治疗和随访方面的临床经验。

结果

呼吸并发症的严重程度取决于脊髓损伤的水平和运动功能完全性的程度。在急性脊髓损伤中,80%的患者可能会出现呼吸并发症。长期随访表明,呼吸并发症是这些患者最常见的死亡原因。最常见的呼吸并发症是肺不张、肺炎和呼吸衰竭。必须立即开始预防呼吸并发症,而不考虑脊髓损伤的水平。在急性情况下以及长期随访期间,都必须解决机械通气问题,同时积极进行分泌物管理。脊髓损伤患者睡眠呼吸暂停的患病率很高,这可能会影响他们的生活质量和康复。

解读

呼吸并发症在脊髓损伤患者中很常见。这些患者需要多学科方法。所有相关学科都必须了解急性期和长期的呼吸并发症情况,以确保患者能得到必要的肺部检查和随访。

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