急性中央颈脊髓损伤临床表现的多样性与不典型性  

Variability and Atypicality in Clinical Spectrum of Acute Central Cord Injury

作　　者：戴力扬[1] 蒋雷生[1] 张家红[1] 崔一民[1] 

机构地区：[1]上海第二医科大学附属新华医院骨科,上海市200092

出　　处：《骨与关节损伤杂志》2003年第9期577-579,共3页The Journal of Bone and Joint Injury

摘　　要：目的 探讨急性中央颈脊髓损伤临床表现的多样性与不典型性及其病理解剖学机制。方法 对1990～2000年收治的97例急性中央颈脊髓损伤作回顾分析。其中男性86例,女性11例。损伤原因多为交通事故伤与高处坠落伤,损伤机制以颈椎过伸性损伤为主。结果 根据上肢是否受累分为四肢型与上肢型两种类型。其中四肢型73例,上肢型24例。根据损伤平面分类C_4髓节损伤5例,C_5髓节损伤36例,C_6髓节损伤29例,C_7髓节损伤16例,C_8髓节损伤7例,记载不详4例。临床表现的不典型性主要表现为两侧肢体运动功能障碍的不对称以及感觉障碍与运动障碍平面、程度的不一致。结论 急性中央颈脊髓损伤的临床表现在一定程度上取决于脊髓的解剖学特点,应根据急性中央颈脊髓损伤的病理解剖学特点对病情作出正确的诊断。Objective To investigate the pathoanatomical mechanism of variability and atypicality in clinical spectrum of the acute central cord injury. Methods Ninety-seven patients with acute central cervical cord injury syndrome, admitted to Xinhua Hospital between 1990 and 2000, were retrospectively reviewed. There were 86 men and 11 women, sustaining mostly in vehicle accident or falling. Hyperextension injury of the cervical vertebrae was the principal mechanism of the injury. Results The patients were divided into upper and lower extremity type (86) and upper extremity type according to extremity involvement, or C4 myelomere injury (5), C5 injury (36), C6 (29), C7 (16) and C8 (7) with four not given in detail, according to injury level. Atypicalinty in clinical spectrum was characterised with asymmetric motor impairment of extremities and inconsistency in the level and degree of sense impairment with motor impairment. Conclusion Clinical manifestations of acute central cord injury is determined, to a certain degree, by the anatomy of. spinal cord, so correct diagnosis should be made based upon the pathoanatomical features of the acute central cervical cord injury.

关 键 词：急性中央颈脊髓损伤 临床表现 多样性 不典型性 

分 类 号：R651.2[医药卫生—外科学]