创伤性颈髓损伤常见急性并发症概述  

A Review of Common Acute Complications of Traumatic Cervical Spinal Cord Injury

作　　者：杜莉 陈坤[1] 

机构地区：[1]广州军区广州总医院OICU科,广州510010

出　　处：《医学综述》2017年第19期3858-3862,共5页Medical Recapitulate

摘　　要：创伤性颈髓损伤(TCSCI)是指因外伤暴力作用于颈椎,通过X线片、CT、磁共振成像检查显示有或无骨折、脱位的一类颈髓损伤。TCSCI患者因运动、感觉功能的缺失,往往会伴发心血管系统、体温调节系统、呼吸系统的病理改变,同时也会影响泌尿系统、消化系统。TCSCI的主要并发症包括神经源性休克、心动过缓、低血压、异位性心搏、体温调节异常、自主神经反射障碍等。其中,自主神经反射障碍是指损伤平面以下的一种自发的交感神经反应,临床症状轻微的有皮疹、头痛,严重的有高血压、脑出血,甚至导致死亡。呼吸系统功能紊乱在TCSCI患者中较为常见,也是致使患者死亡的主要原因。因此,深入了解TCSCI急性期并发症具有重要临床意义,可有效提高诊疗效率。Traumatic cervical spinal cord injury（ TCSCI） is a kind of cervical spinal cord injury caused by trauma or violence,with or without fracture or dislocation displayed through cervical X-ray,CT and magnetic resonance imaging examination. Because of the lack of motor and sensory function,the TCSCI patients often have the pathological changes of the cardiovascular system,thermoregulation system and respiratory system,and adverse effects on the urinary system and digestive system can be observed as well. The main complications of TCSCI include neurogenic shock,bradycardia,hypotension,ectopic cardiac arrest,abnormal body temperature regulation,autonomic reflex disorder and so on. Among them,the autonomic nerve reflex disorder refers to a spontaneous sympathetic response below the injury plane,with the mild clinical symptoms of rash,headache,and severe symptoms of high blood pressure,cerebral hemorrhage,and even death. Respiratory system dysfunction in TCSCI patients is more common,which is also the main cause of death. Therefore,in-depth understanding of TCSCI acute phase complications have great clinical significance,which can effectively improve the diagnosis and treatment efficiency.

关 键 词：创伤性颈髓损伤 自主神经功能障碍 心血管病 直立性低血压 心动过缓 血栓形成 呼吸功能不全 

分 类 号：R683.2[医药卫生—骨科学]