Myllynen P, Kivioja A, Rokkanen P, Wilppula E
Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Paraplegia. 1989 Feb;27(1):19-26. doi: 10.1038/sc.1989.3.
The predictive values of some early post-traumatic clinical symptoms and signs and laboratory tests on the problems, complications and prognosis of the initial treatment of tetraplegic patients were studied. The study was carried out by scrutinizing the files of 54 patients with a cervical spinal cord injury (40 of them complete and 14 incomplete). Most of the patients (n = 43) needed ventilatory support, the duration of which depended on the level and completeness of the spinal cord injury. Bradycardia, hypotonia and tachypnoea at admission occurred most frequently in those patients who later developed complications or died. In addition, the frequency of complications correlated with a patient's age, previous diseases and with the height and degree of the spinal cord injury. Tachypnoea on admission forecast the later development of respiratory complications. All 8 patients who died, 5 of them from pneumonia and 3 from pulmonary embolism, had their spinal cord injury at the level C4 to C5 and they were significantly older than those who survived.
研究了创伤后早期一些临床症状、体征及实验室检查对四肢瘫痪患者初始治疗中的问题、并发症及预后的预测价值。该研究通过查阅54例颈脊髓损伤患者（其中40例为完全性损伤，14例为不完全性损伤）的病历进行。大多数患者（n = 43）需要通气支持，通气支持的持续时间取决于脊髓损伤的平面和完整性。入院时心动过缓、肌张力减退和呼吸急促在后来出现并发症或死亡的患者中最为常见。此外，并发症的发生频率与患者年龄、既往疾病以及脊髓损伤的高度和程度相关。入院时呼吸急促预示着后期会出现呼吸并发症。所有8例死亡患者中，5例死于肺炎，3例死于肺栓塞，他们的脊髓损伤平面均在C4至C5，且年龄显著高于存活患者。
