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缺血性脊髓病和创伤性脊髓损伤后的结局

Outcomes Following Ischemic Myelopathies and Traumatic Spinal Injury.

作者信息

Bonavita Jacopo, Torre Monica, Capirossi Rita, Baroncini Ilaria, Brunelli Elisa, Chiarottini Giorgia, Maietti Elisa, Olivi Silvia, Molinari Marco, Scivoletto Giorgio

机构信息

Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy.

Spinal Unit, IRCCS Fondazione S. Lucia, Rome, Italy.

出版信息

Top Spinal Cord Inj Rehabil. 2017 Fall;23(4):368-376. doi: 10.1310/sci2304-368.

Abstract

As the general population ages, the rising prevalence of vascular lesions of the spinal cord will become significant. The aim of this study was to compare the neurological and functional outcomes of patients with ischemic spinal cord injury (ISCI) and traumatic spinal cord injury (TSCI). We conducted a retrospective study in a spinal cord unit of 2 rehabilitation hospitals. We studied 168 patients with a TSCI and 72 with an ISCI. At admission and discharge, patients were evaluated by American Spinal Injury Association Impairment Scale (AIS) standards and Spinal Cord Independence Measure (SCIM). Length of stay, occurrence of complications, and discharge dispositions were also recorded. Linear and logistic regression models were used to analyze the effects of the etiology of the lesion, AIS level at admission, and level of the lesion. Patients with an ISCI were older and experienced fewer cervical lesions and fewer complete lesions than patients with TSCI. By linear and logistic regression, etiology was a predictor (together with lesion features) of functional (SCIM improvement and SCIM at discharge) outcome, with traumatic patients having better outcome than ischemic ones. Age, AIS level, and lesion level were the chief predictors of length of stay, occurrence of complications, and discharge dispositions. A diagnosis of ischemia and trauma could be a determinant of functional recovery in SCI patients.

摘要

随着普通人群老龄化,脊髓血管病变患病率的上升将变得显著。本研究的目的是比较缺血性脊髓损伤(ISCI)患者和创伤性脊髓损伤(TSCI)患者的神经学和功能预后。我们在2家康复医院的脊髓病房进行了一项回顾性研究。我们研究了168例TSCI患者和72例ISCI患者。在入院时和出院时,根据美国脊髓损伤协会损伤量表(AIS)标准和脊髓独立测量(SCIM)对患者进行评估。还记录了住院时间、并发症的发生情况和出院处置情况。使用线性和逻辑回归模型分析病变病因、入院时AIS水平和病变水平的影响。与TSCI患者相比,ISCI患者年龄更大,颈椎病变和完全性病变更少。通过线性和逻辑回归分析,病因(与病变特征一起)是功能预后(SCIM改善和出院时SCIM)的一个预测因素,创伤患者的预后优于缺血患者。年龄、AIS水平和病变水平是住院时间、并发症发生情况和出院处置的主要预测因素。缺血和创伤的诊断可能是脊髓损伤患者功能恢复的一个决定因素。

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本文引用的文献

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Spinal Cord. 2013 Jun;51(6):453-6. doi: 10.1038/sc.2013.14. Epub 2013 Mar 26.
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Recovery after spinal cord infarcts: long-term outcome in 115 patients.脊髓梗死的恢复:115 例患者的长期结果。
Neurology. 2012 Jan 10;78(2):114-21. doi: 10.1212/WNL.0b013e31823efc93. Epub 2011 Dec 28.

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