老年患者过伸性颈髓损伤的临床特点及相关因素分析  

Clinical characteristics and correlative factor analysis of hyperextensive injuries of cervical spinal cord in the elderly

作　　者：胡玉华[1] 姜景辉[1] 茹江英[1] 殷磊[1] 胡传亮[1] 

机构地区：[1]武警江苏总队医院骨科,扬州225003

出　　处：《武警医学》2010年第4期308-309,312,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨老年患者过伸性颈髓损伤的临床特点、损伤机制、误诊原因及受伤部位与临床疗效的关系。方法根据头面部擦伤痕迹将受伤部位分为:前额部、面颊部和下颌部。根据损伤时日本骨科学会JOA评分、治疗后随访JOA评分,比较治疗前后JOA评分增加幅度。结果作用于额部、面颊部所致脊髓损伤的功能恢复程度优于下颌部受力的脊髓功能恢复程度,有统计学差异(P<0.05)。结论老年患者过伸性颈髓损伤,具有暴力小、损伤重、易漏诊等特点,外力作用于下颌部位所致脊髓损伤较前额部、面颊部可能更为严重;早期确诊、恰当治疗、合理康复锻炼对脊髓功能恢复至关重要。Objective To investigate clinical features, the mechanism of injury, causes of misdiagnosis and other correlative factors of hyperextensive injuries of the cervical spinal cord in the elderly. Methods Fifty - four elderly patients （ aged above 60 ） with hyperextensive injuries of the cervical spinal cord were individed into the forehead group, cheek group and lower mandible group. Their neurological findings pretreatment and post-treatment were assessed according to JOA （ Japanese Orthopaedic Association） rating system. Results JOA score in the lower mandible group was less significant than in the forehead group and the cheek group（ P 〈 0.05 ）. Conclusions Impact on the lower mandihle may resuh in more severe hyperextension injuries than on other parts in the elderly. The key to effective recovery is to make instant and correct diagnosis and proper treatment and rababilitation.

关 键 词：颈髓 过伸伤 老年人 受伤部位 疗效 

分 类 号：R651.2[医药卫生—外科学] R323.4[医药卫生—临床医学]