Song J, Shao J, Qi H-H, Song D-W, Zhu W
Department of Orthopedics, Shanghai Changzheng Hospital, Second Military Medical University of China, Shanghai, People's Republic of China.
Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):9-14.
To analyze risk factors for respiratory failure with tetraplegia after acute traumatic cervical spinal cord injury (CSCI).
Total 180 tetraplegia cases after acute traumatic CSCI treated in Shanghai Changzheng Hospital from 2001 to 2011 were reviewed retrospectively and the frequency of respiratory failure in these patients were analyzed against the factors including age, gender, cause of injury, level/severity of injury, high-dose methylprednisolone (MP) therapy, and surgery intervention, using Chi-square test to look into the correlations of the prevalence of respiratory failure to those factors.
Of the 180 tetraplegia with acute traumatic CSCI, 29 patients (16.11%) developed respiratory failure. The factors, including age, level and severity of injury, high-dose MP therapy, and surgery intervention, were found to significantly correlate with the appearance of respiratory failure in tetraplegia after acute traumatic CSCI (p < 0.05), while no significant correlation was found between the other factors: gender and cause of injury and the frequency of respiratory failure.
Age, level/severity of injury, high-dose MP therapy, and surgery intervention are the four major relevant factors of respiratory failure in patients with acute traumatic CSCI. The appropriate and timing treatments involving high-dose MP therapy and surgical decompression and reconstruction can substantially increase the rates of clinical improvements and reduce the frequency of respiratory failure.
分析急性创伤性颈脊髓损伤（CSCI）后四肢瘫痪并发呼吸衰竭的危险因素。
回顾性分析2001年至2011年在上海长征医院接受治疗的180例急性创伤性CSCI后四肢瘫痪患者，针对年龄、性别、损伤原因、损伤水平/严重程度、大剂量甲基泼尼松龙（MP）治疗及手术干预等因素，分析这些患者呼吸衰竭的发生频率，采用卡方检验研究呼吸衰竭患病率与这些因素的相关性。
180例急性创伤性CSCI后四肢瘫痪患者中，29例（16.11%）发生呼吸衰竭。发现年龄、损伤水平和严重程度、大剂量MP治疗及手术干预等因素与急性创伤性CSCI后四肢瘫痪患者呼吸衰竭的发生显著相关（p<0.05），而其他因素（性别和损伤原因）与呼吸衰竭发生频率无显著相关性。
年龄、损伤水平/严重程度、大剂量MP治疗及手术干预是急性创伤性CSCI患者呼吸衰竭的四个主要相关因素。涉及大剂量MP治疗以及手术减压和重建的恰当且适时的治疗可大幅提高临床改善率并降低呼吸衰竭的发生频率。
