颈脊髓损伤患者早期死亡的危险因素  

Risk factors for early death in patients with cervical spinal cord injury

作　　者：焦新旭[1] 冯世庆[1] 于铁强[1] 李景伟[1] 张学利[1] 邓树才[1] 姜文学[1] 王景贵[1] 

机构地区：[1]天津医科大学总医院骨科,300052

出　　处：《中华创伤杂志》2011年第5期423-427,共5页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目（30872603）;天津市科委发展基金资助项目（10YFJZJC17500）;天津市卫生局科技重点基金资助项目（07KG2）

摘　　要：目的 探讨创伤性颈脊髓损伤患者早期死亡原因和危险因素.方法回顾性分析553例创伤性颈脊髓损伤患者的临床资料,对影响因素进行单因素分析和多因素Logistic回归分析.结果早期死亡率4.0%（22/553）.主要死亡原因为呼吸功能衰竭9例（40.9%）和电解质紊乱5例（22.7%）.单因素分析发现年龄、颈脊髓损伤程度、呼吸、心血管和消化系统、电解质紊乱并发症、气管切开与颈脊髓损伤患者早期死亡有一定相关性（P〈0.05）.多因素Logistic回归分析发现危险因素有年龄、颈脊髓损伤程度、呼吸和心血管系统、电解质紊乱并发症、气管切开.结论 高年龄、颈脊髓损伤程度重、合并呼吸或心血管系统以及电解质紊乱并发症、气管切开是颈脊髓损伤患者早期死亡的高危因素.Objective To explore the causes and risk factors affecting early death in patients with traumatic cervical spinal cord injury （SCI）. Methods Clinical data of 553 patients with traumatic cervical SCI were analyzed retrospectively to discuss the related factors affecting early death of patients with traumatic cervical SCI by using univariate analysis and multivariate logistic regression analysis. Results The early mortality of the patients with traumatic cervical SCI was 4.0% （ 22/553 ）. The main causes of the early death were respiratory failure in nine patients （40.9%） and electrolyte disorders in five （22.7%）. Univariate analysis showed that age, cervical spinal cord injury severity, complications in respiratory, cardiovascular, digestive systems and electrolyte disturbance as well as tracheotomy were considered statistically significant for early death in patients with traumatic cervical SCI （ P 〈 0, 05 ）. Multivariate logistic regression analysis showed that age, cervical SCI severity, complications in respiratory,cardiovascular system and electrolyte disturbance as well as tracheotomy. Conclusion Severe cervical SCI, combined respiratory, cardiovascular system and electrolyte disorder complications as well as tracheotomy are high risk factors for the early death in patients with traumatic cervical SCI.

关 键 词：脊髓损伤 颈 危险因素 早期死亡 

分 类 号：R651[医药卫生—外科学]