| 分阶段策略预防急性颈脊髓损伤呼吸系统并发症的回顾性研究 |
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Received:September 18, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 赖必华 |
LAI Bi-hua |
福建医科大学附属南平市第一医院骨科, 福建 南平 353001 |
Department of Orthopaedics, the First Hospital of Nanping City Affiliated to Fujian Medical University, Nanping 353001, Fujian, China |
laibh1976@126.com |
| 吴建斌 |
WU Jian-bin |
福建医科大学附属南平市第一医院骨科, 福建 南平 353001 |
Department of Orthopaedics, the First Hospital of Nanping City Affiliated to Fujian Medical University, Nanping 353001, Fujian, China |
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| 高招文 |
GAO Zhao-wen |
福建医科大学附属南平市第一医院骨科, 福建 南平 353001 |
Department of Orthopaedics, the First Hospital of Nanping City Affiliated to Fujian Medical University, Nanping 353001, Fujian, China |
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| 连伟飞 |
LIAN Wei-fei |
福建医科大学附属南平市第一医院骨科, 福建 南平 353001 |
Department of Orthopaedics, the First Hospital of Nanping City Affiliated to Fujian Medical University, Nanping 353001, Fujian, China |
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| 期刊信息：《中国骨伤》2015年28卷，第8期，第690-694页 |
| DOI：10.3969/j.issn.1003-0034.2015.08.003 |
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目的:探讨分阶段策略预防急性颈脊髓损伤(ACSCI)呼吸系统并发症的临床效果。
方法:回顾性分析2008年9月至2013年5月手术治疗的91例ACSCI患者的临床资料,其中采用分阶段策略预防呼吸系统并发症42例(分阶段组),男30例,女12例,年龄28～76岁,平均50岁;未采取分阶段策略预防呼吸系统并发症的49例患者作为对照组,男38例,女11例,年龄30～77岁,平均47岁。两组患者均于伤后48 h收入院,且入院时无呼吸系统并发症。分阶段组分为术前、术中及术后3个阶段,并根据不同阶段采取不同措施预防呼吸系统并发症,而对照组无系统及全面措施预防呼吸系统并发症。对两组患者的呼吸系统并发症发生率、由呼吸系统并发症导致气管插管或切开率及病死率进行分析。
结果:分阶段组中10例出现呼吸系统并发症(肺部感染7例,肺不张1例,呼吸衰竭2例),其中3例因呼吸系统并发症而行气管插管或切开;对照组中24例出现呼吸系统并发症(肺部感染15例,肺不张3例,呼吸衰竭6例),其中11例因呼吸系统并发症行气管插管或切开,两组比较差异有统计学意义(χ2= 6.12,4.07;P=0.013,0.044).因呼吸系统并发症导致死亡在分阶段组中1例,对照组中4例,两组比较差异无统计学意义(χ2=1.39,P=0.238).
结论:分阶段策略可降低ACSCI呼吸系统并发症发生率及改善呼吸系统并发症的预后。 |
| [关键词]:急性颈脊髓损伤 呼吸系统并发症 预防 |
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| Strategy by stages for preventing respiratory complications of acute cervical spinal cord injury |
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Abstract:
Objective:To investigate clinical effects of strategy by stages for preventing respiratory complications of patients with acute cervical spinal cord injury(ACSCI).
Methods:From September 2009 to May 2013,the clinical data of 91 patients with ACSCI underwent surgery were retrospectively analyzed. Among the patients,42 patients were divided into in-stages group,including 30 males and 12 females with an average age of 50 years old (ranged 28 to 76),which were treated with strategy by stages for preventing respiratory complications;others 49 patients which were not treated with the strategy regarded as control group,including 38 males and 11 females with an average age of 47 years old (ranged 30 to 77) . All of them had definite history of trauma,and were admitted to orthopaedics within 48 h after trauma. In in-stages group,respiratory muscle strength training,high-dose ambroxol using and other treatment were performed to prevent respiratory complilcations according to preoperative,intraoperative and postoperative stage. While in control group,there were no systematic and effective measures utilized. Chi-square test was used to evaluate the difference for respiratory complications rate,the rate of tracheostomy or intubation and mortality caused by the respiratory complications between two groups.
Results:Ten patients developed with respiratory complications in in-stages group (7 patients with pneumonia,1 with atelectasis and 2 with respiratory failure),among which 3 patients underwent tracheostomy or intubation. In control group,24 patients developed with respiratory complilcations (15 with pneumonia,3 with atelectasis and 6 with respiratory failure),among which 11 patients underwent tracheostomy or intubation. There was significant difference between two groups (χ2=6.12,4.07;P=0.013,0.044). Five patients died because of respiratory complications,one case were in in-stages group and 4 in control group. There was significant difference between two groups (χ2=1.39,P=0.238).
Conclusion:The strategy by stages is an effective method for preventing respiratory complications of ACSCI and can reduce the respiratory complications rate and improve the prognosis of respiratory complications |
| KEYWORDS:Acute cervical spinal cord injury Respiratory complications Prevention |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赖必华,吴建斌,高招文,连伟飞.分阶段策略预防急性颈脊髓损伤呼吸系统并发症的回顾性研究[J].中国骨伤,2015,28(8):690~694 |
| 英文格式: | LAI Bi-hua,WU Jian-bin,GAO Zhao-wen,LIAN Wei-fei.Strategy by stages for preventing respiratory complications of acute cervical spinal cord injury[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(8):690~694 |
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