临床医生对脊髓损伤的看法

摘要(中文译文)

脊髓损伤（SCI）的主要原因是机动车碰撞，其次是暴力、跌倒和运动赛事中的损伤。患者最常见为年轻男性。无论病因和年龄如何，SCI都是一种潜在的灾难性损伤。脊髓独特的解剖关系——被包裹在骨性椎管内的硬膜囊中——使其容易受到多种创伤性损害的侵袭。SCI分为完全性和不完全性，在这两个类别下各自又分为若干亚类。不完全性损伤患者恢复至功能状态的可能性通常更大。SCI的治疗包括最初固定受伤的脊柱、使用药物预防继发性损伤，以及可能的手术以解除对脊髓的压迫并恢复脊柱的稳定性。术后护理主要针对SCI继发性并发症的预防和治疗，如呼吸衰竭、深静脉血栓形成和褥疮溃疡。这些领域的进展为患者提供了更高的康复概率、更长的寿命和更好的生活质量。临床和基础科学的研究正在为脊髓损伤患者开辟新的希望之路。

Abstract

The primary cause of spinal cord injury (SCI) is automobile collisions, followed by violence, falls, and injuries in sporting events. The patient is most frequently a young male. Regardless of cause and age, SCI is a potentially catastrophic injury. The unique anatomical relationship of the spinal cord, being enclosed in the dural sac within the bony vertebral column, make it venerable to a wide range of traumatic insults. SCI is classified as complete or incomplete with several subclasses arranged under each of these respective headings. The probability of recovery to a functional state is usually better for patients with incomplete injuries. Treatment for SCI involves initially immobilizing the injured vertebral column, medications to prevent secondary injury, and potential surgery to release pressure on the spinal cord and restore stability to the vertebral column. Postsurgical care is directed toward prevention and treatment of secondary complications of SCI such as respiratory failure, deep venous thrombosis, and decubitus ulcers. Advances in these areas are providing patients with a greater probability of recovery, a longer life, and a better quality of life. Research in the clinical and basic sciences is opening new avenues of hope for the spinal cord injury patient.

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