胸腰椎体骨折合并脊髓损伤患者的生存状况及其危险因素分析  

Factors influencing survival condition of thoracolumbar spinal injury combined with spinal cord injury

作　　者：张德盛[1] 刘树平[1] 刘跃洪[1] 周宇[1] 陈曦[1] 周庆[1] 

机构地区：[1]四川省德阳市人民医院骨科,618000

出　　处：《疑难病杂志》2015年第10期1067-1069,1073,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析胸腰椎体骨折合许脊髓损伤患者的生存状况及其危险因素。方法选择2010年1月—2013年10月诊断为胸腰椎骨折合并脊髓损伤的80例患者作为研究对象,随访1年分析患者生存状况,许根据患者生存状况分为预后良好组(56例)与预后差组(24例),采用回顾性方法记录相关信息,筛选出影响该类患者生存状况的相关因素,并用Logistic回归分析进行多因素回归分析危险因素。结果治疗后患者均未出现脊髓损伤恶化表现,随访1年24例(30.0%)患者未达到预后良好标准。治疗后预后良好组患者脊柱后突Cobb's角、椎体前缘及后缘高度的压缩率均较预后差组患者低,差异有统计学意义(P<0.05)。年龄、病程、椎管侵占率及使用激素与胸腰椎骨折合并脊髓损伤患者生存状况存在相关性,差异有统计学意义(P<0.05);多因素回归分析发现年龄≥60岁、病程≥7 d、椎管侵占率>50.0%是胸腰椎骨折合并脊髓损伤患者生存状况差的独立危险因素,即时使用激素是胸腰椎骨折合并脊髓损伤患者生存状况差的保护因素(P<0.05)。结论高龄、病程长、椎管侵占率大是胸腰椎骨折合并脊髓损伤患者预后差的独立危险因素,临床上早期规律使用激素可有效改善脊髓损伤患者术后脊髓功能预后。Objective To investigate the survival status of patients with thoracolumbar vertebral body fracture com -bined with spinal cord injury , and to analyze its risk factors .Methods From January 2010 to October 2013 , 80 patients with thoracolumbar fractures combined with spinal cord injury were selected as the research object .The patients were followed up for 1 year.The patients were divided into good prognosis group （56 cases） and poor prognosis group （24 cases）.The related factors of influencing the survival status of the patients were selected by the retrospective method , and the risk factors were an-alyzed by Logistic regression analysis .Results After treatment , there was no deterioration of spinal cord injury , and 24 cases （30.0%） were not reached the good prognosis standard after followed up for 1 year.After treatment, the good prognosis group’s spine Cobb＇s angle, vertebral anterior and posterior height ’s compression ratio was lower compared with the poor prog-nosis group.The difference was statistically significant （ P 〈0.05）.Age, course of disease, spinal canal encroachment rate and the use of hormone and thoracolumbar fractures combined with spinal cord injury patients ’ living conditions existed corre-lation, the difference was statistically significant （ P 〈0.05）;multi factor regression analysis showed that age is more than or equal to 60 years, course of disease is more than or equal to 7 days, spinal canal occupation rate 〉50.0%is the poor inde-pendent risk factors for survival status of patients with thoracolumbar vertebral fracture combined with spinal cord injury , the immediate use of the hormone is protection factors for survival status of patients with thoracolumbar fractures combined with spinal cord injury （ P 〈0.05）.Conclusion Elderly patients with advanced disease , and spinal canal occupation rate are the independent risk factors for poor prognosis of thoracolumbar fractures combined with spinal cord injury , and early clinical use of hormone can

关 键 词：胸腰椎体骨折 脊髓损伤 生存状况 危险因素 

分 类 号：R687.3[医药卫生—骨科学] R651.2[医药卫生—外科学]