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脊髓损伤的关键管理:一项叙述性综述。

The Critical Management of Spinal Cord Injury: A Narrative Review.

作者信息

Moreno-González Emilio, Ibarra Antonio

机构信息

Centro de Investigación de Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte, Huixquilucan CP 52786, Estado de México, Mexico.

出版信息

Clin Pract. 2024 Dec 26;15(1):2. doi: 10.3390/clinpract15010002.

Abstract

Spinal cord injury (SCI) is defined as physical damage that alters the function and structure of the spinal cord. Traumatic causes, such as vehicle accidents, falls, and violence, account for 90% of SCI cases. Recent evidence suggests that early intensive care unit (ICU) monitoring improves patient prognosis, highlighting the importance of prompt ICU admission and early decompression surgery. This review includes 50 publications selected based on specific criteria to gather evidence on the current management of SCI in acute settings. Pharmacological agents have been studied for their neuroprotective properties, offering hope for improved neurological outcomes. Several clinical trials are evaluating new pharmacological alternatives for SCI. In conclusion, the current management of acute SCI should focus on standardized treatments addressing ventilatory, cardiopulmonary, and hematologic complications, all of which directly impact long-term neurological and functional prognosis. New neuroprotective agents currently in clinical trials show promising results and should be further studied to determine their role in acute SCI management.

摘要

脊髓损伤(SCI)被定义为改变脊髓功能和结构的物理损伤。诸如车祸、跌倒和暴力等创伤性原因占脊髓损伤病例的90%。最近的证据表明,早期重症监护病房(ICU)监测可改善患者预后,凸显了及时入住ICU和早期减压手术的重要性。本综述纳入了根据特定标准挑选的50篇出版物,以收集关于急性情况下脊髓损伤当前管理的证据。人们已经研究了药物制剂的神经保护特性,为改善神经学结果带来了希望。多项临床试验正在评估用于脊髓损伤的新药理学替代方案。总之,急性脊髓损伤的当前管理应侧重于针对通气、心肺和血液学并发症的标准化治疗,所有这些并发症都会直接影响长期神经学和功能预后。目前正在进行临床试验的新型神经保护剂显示出有前景的结果,应进一步研究以确定它们在急性脊髓损伤管理中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/824a/11840280/bf4a9da4b35f/clinpract-15-00002-g001.jpg

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