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小儿创伤性脊髓损伤患者的临床特征及合并症评估

Evaluation of Clinical Characteristics and Comorbid Conditions in Pediatric Traumatic Spinal Cord Injury Patients.

作者信息

Erden Ender

机构信息

Physical Medicine and Rehabilitation, Hitit University Faculty of Medicine, Çorum, TUR.

出版信息

Cureus. 2023 Sep 1;15(9):e44512. doi: 10.7759/cureus.44512. eCollection 2023 Sep.

Abstract

Objective This study aimed to examine the demographic features and the most common comorbid conditions of pediatric traumatic spinal cord injury (SCI) patients who were admitted to Ankara Physical Therapy and Rehabilitation Training and Research Hospital's inpatient rehabilitation program. Materials and methods The demographic features, clinical features and cormorbid conditions of 147 pediatric traumatic SCI patients (age of injury 17 and under) who received an inpatient rehabilitation program in the hospital between 2009-2017 were retrospectively examined. Patients were divided into three groups according to the lesion location (cervical, thoracic, and lumbar); and into two groups according to the age of completing the development of osteoligamentous structures in the vertebral column (group 1: ≤ 10 years and group 2: >10 years), and the evaluated data were compared. Results 73.5% of the patients were male, the average age of injury was 13.60 ± 4.19 years, and the average duration of the disease was 11.17 ± 20.80 months. The most common etiological reason was falls from height (34.7%), and the most common level of injury was the thoracic region (49%). The most common comorbid conditions after SCI were found to be neurogenic bladder (91.2%), spasticity (41.54%), and neuropathic pain (29.3%). It was determined that neurogenic bladder was seen less in the lumbar region (p<0.001). Urinary tract infection was found more in the cervical group (p=0.004). In Group 1 (0-10 years), the median disease duration was longer, and the rate of thoracic region injury and complete injury was higher (p<0.05); in Group 2 (11-17 years), the rate of having stabilization operation after the injury was significantly higher (p<0.001). Conclusion It is crucial to prevent the etiological reasons in pediatric traumatic SCI patients, to treat the arising comorbid conditions in the early period, to take protective measures, and to follow up the patients regularly when necessary.

摘要

目的 本研究旨在调查入住安卡拉物理治疗与康复培训及研究医院住院康复项目的小儿创伤性脊髓损伤(SCI)患者的人口统计学特征和最常见的合并症。材料与方法 回顾性研究了2009年至2017年间在该医院接受住院康复项目的147例小儿创伤性SCI患者(受伤年龄17岁及以下)的人口统计学特征、临床特征和合并症。根据损伤部位(颈椎、胸椎和腰椎)将患者分为三组;根据脊柱骨韧带结构发育完成的年龄分为两组(第1组:≤10岁和第2组:>10岁),并对评估数据进行比较。结果 73.5%的患者为男性,平均受伤年龄为13.60±4.19岁,平均病程为11.17±20.80个月。最常见的病因是高处坠落(34.7%),最常见的损伤部位是胸椎区域(49%)。SCI后最常见的合并症是神经源性膀胱(91.2%)、痉挛(41.54%)和神经性疼痛(29.3%)。发现神经源性膀胱在腰椎区域较少见(p<0.001)。颈椎组尿路感染较多(p=0.004)。在第1组(0-10岁)中,中位病程较长,胸椎区域损伤和完全损伤的发生率较高(p<0.05);在第2组(11-17岁)中,受伤后进行稳定手术的发生率显著较高(p<0.001)。结论 预防小儿创伤性SCI患者的病因、早期治疗出现的合并症、采取保护措施以及在必要时定期随访患者至关重要。

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