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冬季运动所致创伤性颈脊髓损伤合并髓内出血和水肿患者急诊手术后预后的影响因素

Influential factors of the prognosis of patients with winter sports-induced traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema after emergency surgical treatment.

作者信息

Zhang Peinan, Yang Xinming, Yin Yanlin, Yao Yao

机构信息

Peinan Zhang, Department of Orthopedic, The First Hospital Affiliated to Hebei North University, Zhangjiakou 075000, Hebei, China.

Xinming Yang, Department of Orthopedic, The First Hospital Affiliated to Hebei North University, Zhangjiakou 075000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Mar-Apr;40(4):617-622. doi: 10.12669/pjms.40.4.7644.

Abstract

OBJECTIVE

To explore relevant influencing factors of the prognosis of patients with winter sports-induced traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema after emergency surgical treatment.

METHODS

A retrospective analysis was performed on 73 cases of traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema in The First Hospital Affiliated to Hebei North University from January 2020 to October 2022. The enrolled patients were divided into the good prognosis (n=17) group and poor prognosis (n=56) group according to the recovery of neurological function after six months of follow-up. The risk factors affecting the prognosis of patients with traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema after emergency surgery were analyzed by binary Logistic regression.

RESULTS

Among the enrolled 73 patients with traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema, 56 cases showed significant improvement in ASIA Grade-6 months after operation, with an improvement rate of 76.71%. Further Logistic regression analysis revealed that concomitant diabetes, preoperative MSCC>40.83% and recovery rate of AMS <40.13% 3d after operation were independent risk factors affecting the poor prognosis of patients with traumatic cervical spinal cord injury complicated with intramedullary hemorrhage and edema.

CONCLUSIONS

Emergency surgery can improve the neurological function of patients with cervical spinal cord injury complicated with intramedullary hemorrhage and edema caused by winter sports. Concomitant diabetes, preoperative MSCC and recovery rate of AMS 3d after operation are the main factors affecting the prognosis of patients with emergency surgery.

摘要

目的

探讨冬季运动所致创伤性颈髓损伤合并髓内出血和水肿患者急诊手术后预后的相关影响因素。

方法

回顾性分析河北北方学院附属第一医院2020年1月至2022年10月收治的73例创伤性颈髓损伤合并髓内出血和水肿患者。根据随访6个月后神经功能恢复情况,将纳入患者分为预后良好组(n = 17)和预后不良组(n = 56)。采用二元Logistic回归分析急诊手术后影响创伤性颈髓损伤合并髓内出血和水肿患者预后的危险因素。

结果

纳入的73例创伤性颈髓损伤合并髓内出血和水肿患者中,56例术后6个月时ASIA分级有显著改善,改善率为76.71%。进一步的Logistic回归分析显示,合并糖尿病、术前MSCC>40.83%以及术后3天AMS恢复率<40.13%是影响创伤性颈髓损伤合并髓内出血和水肿患者预后不良的独立危险因素。

结论

急诊手术可改善冬季运动所致颈髓损伤合并髓内出血和水肿患者的神经功能。合并糖尿病、术前MSCC以及术后3天AMS恢复率是影响急诊手术患者预后的主要因素。

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