摘要
目的:探讨脊髓损伤后髋关节周围发生异位骨化的危险因素。方法:将1023例外伤性脊髓损伤患者根据X线检查和CT检查分为异位骨化组(A组,121例)和无异位骨化组(B组)。比较两组患者的年龄、性别、脊髓损伤情况、脊髓损伤到瘫痪肢体开始功能训练的时间、血清钙浓度、痉挛及压疮发生情况,分析与异位骨化相关的危险因素。结果:异位骨化发生率为11.8%。A组与B组患者的年龄、性别、脊髓损伤至瘫痪肢体开始功能训练的时间、血清钙浓度及压疮发生率经统计学比较无显著性差异(P>0.05)。A组患者中完全性瘫痪者及痉挛性瘫痪者比例较高,与B组比较差异非常显著(P<0.01)。A组患者脊髓损伤主要位于颈段及中胸段,与B组比较有非常显著性差异(P<0.01)。A组患者脊髓损伤主要为ASIAA级和B级,与B组比较有非常显著性差异(P<0.01)。痉挛性瘫痪改良AshworthⅡ级以上者异位骨化发生率较高,统计学比较差异非常显著(P<0.01)。结论:完全性脊髓损伤及痉挛性瘫痪是脊髓损伤后异位骨化发生的主要危险因素。脊髓损伤神经功能分级为ASIAA级和B级者、颈段或中胸段脊髓损伤者及痉挛性瘫痪改良AshworthⅡ级以上者易发生异位骨化。
Objective：To evaluate the risk factors in heterotopic ossification（HO） around the hip after spinal cord injury （SCI）.Method：1023 cases with traumatic SCI were reviewed retrospectively,of which 121 cases were found HO around the hip by X-ray and CT scan （group A）,and the others without HO were looked as group B.The gender and age,the degree of SCI,the interval between SCI and the start of passive movements, serum calcium levels,spasticity,pressure ulcers of the two groups were studied to explore the risk factors related to HO formation.Resnlt：The incidence of HO was about 11.8%.There was no statistical significance in gender,age,the interval between SCI and the start of passive movements,serum calcium levels and pressure ulcer between group A and group B.There were more patients with complete SCI and spasticity in group A （P〈0.01）.There were more patients with cervical and mid-thoracic spinal cord lesions in group A,and more with ASIA grade A and B（P〈0.01 ）.There was a higher incidence of HO in the patients with spasticity above modified Ashworth grade Ⅱ （P〈0.01）.Conclusion：Complete SCI and spasticity are risk factors related to the HO formation after traumatic SCI.HO are apt to develop in patients with ASIA grade A and B,and in those with cervical and mid-thoracic spinal cord lesions.HO are apt to develop in patients with spasticity above modified Ashworth grade Ⅱ.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2006年第6期429-432,共4页
Chinese Journal of Spine and Spinal Cord
关键词
脊髓损伤
异位骨化
危险因素
Spinal cord injury
Heterotopic ossification
Risk factors
