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作 者:中华医学会骨科学分会 中国医师协会骨科医师分会 中国研究型医院学会神经再生与修复专业委员会脊柱损伤与功能重建学组 中国康复医学会脊柱脊髓专业委员会脊柱脊髓损伤与康复学组 中国康复医学会脊柱脊髓专业委员会脊柱脊髓基础研究学组 武汉协和中加脊柱脊髓损伤中心 张英泽 冯世庆 孙天胜 王玉龙 沈先涛[6] 郭晓东[7] Chinese Orthopedic Association,Chinese Association of Orthopedic Surgeons;Group of Spinal Injury and Functional Reconstruction,Neural Regeneration and Repair Committee,Chinese Research Hospital Association;Spinal Cord Injury and Rehabilitation Group,Spinal Cord Committee of Chinese Association of Rehabilitation Medicine;Spinal Cord Basic Research Group,Spinal Cord Committee of Chinese Society of Rehabilitation Medicine;Sino-Canada Spinal and Spinal Cord Injury Center of Wuhan Union Hospital;Zhang Yingze;Feng Shiqing;Sun Tiansheng;Wang Yulong;Shen Xiantao;Guo Xiaodong
机构地区:[1]不详 [2]河北医科大学第三医院 [3]天津医科大学总医院 [4]解放军总医院第七医学中心 [5]华中科技大学同济医学院附属武汉中西医结合医院 [6]武汉儿童医院 [7]华中科技大学同济医学院附属协和医院
出 处:《中华创伤杂志》2022年第9期776-784,共9页Chinese Journal of Trauma
摘 要:儿童急性过伸性脊髓损伤(PAHSCI),又称为儿童下腰瘫,主要发生在儿童下腰训练中,多为完全性脊髓损伤,其发生率呈逐年上升趋势;大部分PAHSCI患者终身残疾,给患者、家庭及社会带来了沉重的经济负担。由于目前国内外均缺乏PAHSCI相关诊疗指南,很多专科医师对此类损伤的预防、临床特点、治疗及预后等认识不足。PAHSCI早期神经症状不典型,未引起重视;患者就诊过程中易误诊,同时目前尚无有效的治疗方法,患者预后差、并发症多。因此,中华医学会骨科学分会、中国医师协会骨科医师分会等组织国内相关专业专家,本着科学性和实用性原则共同制订了《儿童急性过伸性脊髓损伤诊疗指南(2022版)》。本指南从PAHSCI的诊断、发病机制、神经功能评估、治疗、预后评估、并发症及预防等方面提出基于循证医学的建议,规范PAHSCI诊断、治疗及预防。Pediatric acute hyperextension spinal cord injury(PAHSCI),also named as pediatric back bend paralysis,mainly occurs in back-bend training.PAHSCI is complete in most conditions and has an increasing incidence each year.Most patients with PAHSCI have lifelong disability,bringing a heavy economic burden to themselves,their families and society.However,due to lack of clinical guideline for the diagnosis and treatment of PAHSCI at home and abroad,many specialists reveal insufficient knowledge to the prevention,clinical characteristics,treatment and prognosis of this type of injury.PAHSCI may be overlooked as the early neurological symptoms are atypical,and is most likely to be misdiagnosed during the visit.At present,there is no effective treatment,together with poor prognosis and numerous complications.Accordingly,the expert team organized by Chinese Orthopedic Association and Chinese Association of Orthopedic Surgeons,etc,developed the"Guideline for the diagnosis and treatment of pediatric acute hyperextension spinal cord injury(2022 version)"in accordance with the principle of scientificity and practicability to give evidence-based recommendations on PAHSCI from aspects of the diagnosis,etiology,neurological assessment,treatment,prognosis evaluation,complication and prevention,hoping to standardize the diagnosis,treatment and prevention.
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