摘要
目的研究不同因素对重度创伤性颈脊髓损伤患者伤后生存时间的影响,为临床治疗和术后康复提供依据。方法回顾性分析自2010-01—2018-05因重度创伤性颈脊髓损伤而死亡的65例临床资料,通过最优尺度回归分析影响患者生存时间的危险因素。结果 65例中位生存时间为89 d,第25个百分位数是16.3 d,第75个百分位数是343 d。伤后2周内死亡15例(23.1%),伤后3个月内死亡34例(52.3%),伤后1年内死亡53例(81.5%)。最优尺度回归分析结果显示,脊髓损伤责任节段、ASIA分级、手术时机、呼吸机依赖时间是影响患者伤后生存时间的重要因素,差异有统计学意义(P<0.05)。责任节段为C_(5～8)、ASIA分级为B级的患者伤后生存时间较长,呼吸机依赖时间越长的患者伤后生存时间越短。结论完全性脊髓损伤、损伤节段高的患者早期死亡风险较高,伤后1周内行手术治疗可以延长患者的生存时间,而术后呼吸机依赖时间是预测患者伤后生存时间的重要指标。
Objective To investigate the relationship between different clinical characteristics and the survival time of patients with severe traumatic t-ervical spinal cord injuiy, so as to provide evidence for clinical treatment and postoperative rehabilitation. Methods The clinical data of 65 patients who died from severe traumatic cervical spinal coni injury from January 2010 to May 2018 were analyzed retrospectively, and the optimal scale regression analysis was used to analyze the risk factors affecting the posttraumatic survival time of patients. Results The median survival time in 65 cases was 89 days, the 25th percentile was 16.3 days, and the 75th percentile was 343 days. Fifteen cases (23.1%) died in 2 weeks afler injurv. 34 cases died in 3 months after injury (52.3%), 53 case died in one year after injury (81.5%). The results of optimal scale regression analysis showed that injury segment. ASIA grade, timing to operation and ICU time after spinal cord injury were important fcictors affecting the posttraunuitic sui-vival time of patients, and the difference was statistically significant (P <0.05). Patients with the injure segment of C5-C8 and ASIA B had a Ion ger survival time after injury, and the longer the ICL time, the shorter the posttrainnatic survival time of the patients. Conclusion In patients with complete spinal cord injun and high injury segment, the risk of early death is higher, surgery in a week after injury can prolong the survival time of patients, and ventilator dependence time after injure is an important predictor of the posttraumatic survival time of patients.
作者
刘趁心
侯绪良
孟冰
白皓
李耀斌
杨照
赵晓蕾
冯亚非
赵雄
雷伟
吴子祥
LIU Chen-xin;HOU Xu-liang;MENG Bing;BAO Hao;LI Yao-bin;YANG Zhao;ZHAO Xiao-lei;FEN Ya-fei;ZHAO Xiong;LEI Wei;WU Zi-xiang(Department of Orthopedics,the First Affiliated Hospital of the Air Force Military Medical University,Xi'an,Shacuixi 710032,China)
出处
《中国骨与关节损伤杂志》
2019年第3期229-232,共4页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金面上项目(81772310)
关键词
重度创伤性颈脊髓损伤
生存时间
最优尺度回归模型
Severe traumatic cervical spinal cord injury
Survival time
Optimal scale regression model
