脊髓损伤 spinal cord injury - PubMed 文献(第 4 页)
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脊髓损伤 的 PubMed 搜索结果(第 4 页)
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31. Depression in spinal cord injured patients.
31. 脊髓损伤患者的抑郁PMID:期刊:Paraplegia PubMed日期:1981[中文摘要] 许多人将抑郁视为脊髓损伤不可避免的心理后遗症。这一假设若并不准确，可能会干扰康复过程。我们采用标准化访谈和诊断流程，对22例近期发生脊髓损伤（不足6个月）的患者进行了评估。5例患者（22%）在损伤后出现了可诊断的抑郁。这一比例高于一般人群中抑郁的发生率，但低于预期。
[英文摘要] Many regard depression as an inevitable psychological sequela of spinal cord injury. This assumption, if inaccurate, may confound the rehabilitation process. We evaluated 22 patients with recent spinal cord injuries (less than 6 months), using a standardised interview and diagnostic process. Five patients (22 per cent) had diagnosable depressions after their injury. This is higher than the incidence of depression in the general population, but less than anticipated.
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32. The Second Hit Hypothesis in Animal and Human Dystonia: The Role of Peripheral Nerve Trauma and Spinal Cord Injury.
32. 动物和人类肌张力障碍中的二次打击假说：周围神经创伤和脊髓损伤的作用PMID:日期:2025-10-14[中文摘要] 肌张力障碍是一种复杂的运动障碍，以不自主肌肉收缩和异常姿势为特征。尽管遗传因素已被认为参与肌张力障碍的发病机制，但近期证据提示，额外的环境触发因素（被称为“二次打击”）可能在疾病的发生和进展中发挥重要作用。某些单基因型肌张力障碍的外显率极低，这支持了需要额外触发因素来揭示表型的观点。鉴于已有报道显示肌张力障碍可在创伤事件后发生，本综述探讨了肌张力障碍动物模型中的二次打击假说及其与人类肌张力障碍的潜在相关性，特别强调神经损伤和脊髓损伤的作用。这些损伤引发显著的外周改变以及深刻的脑和脊髓环路变化，而这些变化需要健康的免疫系统以及功能性和结构性可塑性反应。我们讨论了神经损伤和脊髓损伤如何启动这些关键的病理机制过程，包括神经炎症和中枢感觉运动网络的重组，后者涉及神经通路的适应性修饰以代偿损伤。我们进一步强调了神经损伤和脊髓损伤诱导的肌张力障碍所面临的未来挑战及潜在治疗意义。理解神经损伤、脊髓损伤、神经炎症与肌张力障碍之间的相互作用，可能为针对这些因素的新型治疗策略铺平道路。
[英文摘要] Dystonia is a complex movement disorder characterized by involuntary muscle contractions and abnormal postures. Although genetic factors have been implicated in dystonia pathogenesis, recent evidence suggests that additional environmental triggers, referred to as the second hit, may play a significant role in the development and progression of the disease. A remarkably low penetrance in some of the monogenic forms of dystonia supports the need for additional triggers to unmask the phenotype. Given that dystonia has been reported to develop after traumatic events, this review explores the second hit hypothesis in animal models of dystonia and its potential relevance to human dystonia, with particular emphasis on the role of nerve and spinal cord injuries. These injuries trigger significant peripheral changes and profound brain and spinal cord circuit alterations, which require a healthy immune system and functional and structural plasticity responses. We discuss how nerve and spinal cord injuries initiate these key pathomechanistic processes, including neuroinflammation and the reorganization of the central sensorimotor network, which entails adaptive modifications in neural pathways to compensate for the injury. We further highlight future challenges and potential therapeutic implications of nerve and spinal cord injury-induced dystonia. Understanding the interplay between nerve injury, spinal cord injury, neuroinflammation, and dystonia may pave the way for novel therapeutic strategies targeting these factors. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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33. Relationship between nutritional status and mortality during the first 2 weeks following treatment for cervical spinal cord injury.
33. 颈段脊髓损伤治疗后前2周营养状况与死亡率的关系PMID:日期:2013-10-24[中文摘要] 营养对颈段脊髓损伤（CSCI）患者死亡率的影响与其他危险因素不同，相关文献记载较少。目的：探讨接受治疗的CSCI患者动态营养状态变化与死亡率之间的关系。方法：对2006年3月至2011年3月期间在北京军区总医院接受治疗的128例CSCI患者进行回顾性研究。评估早期治疗阶段（<14天）的年龄、脊髓损伤节段（C1-C4和C5-C7）、美国脊髓损伤协会（ASIA）分级、住院时间、通气支持及血清蛋白水平（总蛋白、血清白蛋白和血清前白蛋白）。根据急性住院的最终结局分为存活组（n=109）和死亡组（n=19）。结果：存活组在早期治疗期间总蛋白水平无显著变化，而死亡组总蛋白水平下降。血清前白蛋白和白蛋白水平在治疗第1天即显著下降，并贯穿整个治疗过程（P<0.05）。在第3-5天及之后，死亡组的血清蛋白水平显著低于存活组（P<0.05）。多节段损伤、ASIA分级较高及通气支持时间较长在死亡组中更为常见（P<0.001）。结论：与低蛋白血症和营养不良相关的较低血清蛋白水平是CSCI患者死亡的重要指标，同时损伤平面较高、ASIA分级较高及通气支持时间较长也是重要指标。对低白蛋白血症进行早期纠正治疗可能有助于降低CSCI患者的死亡率。
[英文摘要] The effects of nutrition on the mortality of cervical spinal cord injury (CSCI) patients, unlike other risk factors, are poorly documented. Objective The relationship between dynamic nutritional status change and mortality in patients treated for CSCI was investigated. A retrospective study of 128 patients treated for CSCI at the Beijing Army General Hospital was conducted between March 2006 and March 2011. Age, spinal segment damage (C1-C4 and C5-C7), American Spinal Injury Association (ASIA) grade, hospitalization duration, ventilatory support, and serum protein levels (total protein, serum albumin, and serum prealbumin) were assessed during early-stage treatment (<14 days). Survival (n = 109) and death (n = 19) groups were assigned by final disposition of acute hospitalization. The survival group evidenced no significant changes in total protein levels during early-stage treatment, although these values decreased in the death group. Serum prealbumin and albumin levels significantly declined by treatment day 1 and throughout treatment (P < 0.05). By days 3-5 and thereafter, significantly lower serum proteins were observed in the death group compared to the survival group (P < 0.05). Multiple segment damage, elevated ASIA, and longer ventilatory support duration were more prevalent in the death group (P < 0.001) CONCLUSIONS: Lower serum protein levels associated with hypoproteinemia and malnutrition are significant indicators of mortality in patients with CSCI, along with higher levels of lesions, elevated ASIA grades, and longer ventilatory support durations. Early corrective action for hypoalbuminemia may help to reduce mortality in patients with CSCI.
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34. Iatrogenic spinal cord injury with tetraplegia after an elective non-spine surgery with underlying undiagnosed cervical spondylotic myelopathy: Literature review and case report.
34. 在未确诊的潜在脊髓型颈椎病情况下，择期非脊柱手术后并发四肢瘫痪的医源性脊髓损伤：文献综述与病例报告PMID:日期:2019-11-02[中文摘要] 脊髓型颈椎病（CSM）可使患者在非脊柱手术中易于发生急性脊髓损伤和术后四肢瘫，尽管文献中对此现象的报道较少。据我们所知，文献中仅有18例报道，包括我们的病例，均为未确诊的CSM患者在择期非脊柱手术后发生脊髓损伤。由于病理生理机制的多因素性，维持颈椎中立位并不足以确保这些患者术中不发生脊髓损伤，因为这仅解决了静态因素的作用。必须警惕影响脊髓灌注和血管损害的因素，如平均动脉压（MAP）。此外，鉴于这些患者存在基线椎管狭窄，进一步研究应评估体位在脊髓病患者中的作用，以及机器人手术中常用的陡峭头低脚高位是否会导致脊髓静脉淤血并由此引起脊髓缺血。本综述阐明了在我们日益老龄化的患者群体中，对这种常见退行性疾病保持高度警惕的重要性，它往往是一种被遗忘的潜在医学合并症。
[英文摘要] Cervical spondylotic myelopathy (CSM) can predispose to acute spinal cord injury and post-operative quadriparesis during non-spine procedures, although few accounts of this phenomenon exist within the literature. To the best of our knowledge, there are only 18 cases reported in the literature including ours with spinal cord injury following elective non-spine surgery with undiagnosed CSM. Due to multifactorial pathophysiology, the maintenance of cervical cord neutrality is not sufficient to ensure that these patients will not sustain cord injury intraoperatively as this solely addresses the role of static factors. Vigilance to factors affecting cord perfusion and vascular compromise, such as the mean arterial pressure (MAP), is imperative. Additionally, further studies should evaluate the role of positioning in the myelopathic patient and whether the steep Trendelenburg position, commonly used in robotic surgeries, contributes to spinal cord venous congestion and resultant cord ischemia in these patients given their baseline stenotic canal. This review illustrates the importance of having a heightened awareness of this common degenerative condition in our aging patient population, often a forgotten underlying medical comorbidity.
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35. Management of spinal cord injury in a general hospital in rural India.
35. 印度农村地区综合医院中脊髓损伤的管理PMID:期刊:Paraplegia PubMed日期:1986-10[中文摘要] 对印度农村一所综合医院收治的218例脊柱损伤患者进行了分析。其中125例存在神经功能缺损。脊柱损伤最常见的原因是從树上坠落（55.2%）。这些患者的救援和转运系统不完善，且缺乏关于转运患者时应采取何种预防措施的知识。褥疮溃疡和尿路感染的发生率高得令人难以接受。颈椎损伤患者的病死率很高。该研究强调了采取适当预防措施的必要性，并再次凸显了综合医院在脊髓损伤患者治疗方面的不足。
[英文摘要] Two hundred eighteen patients with spinal injury treated in a general hospital in rural India are analysed. One hundred and twenty-five of them had neurological deficit. The commonest cause for spinal injury was falling from trees (55.2%). Rescue and retrieval systems for these patients were inadequate and knowledge regarding precautions to be taken when transporting the patient was lacking. The frequency of decubitus ulceration and of urinary tract infections were unacceptably high. A high percentage of patients with cervical spine injury expired. The study highlights the necessity for appropriate preventive measures, and also reemphasizes the short-comings of treatment of spinal cord injury patients in general hospitals.
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36. Spinal cord injury: preventing secondary injury.
36. 脊髓损伤：预防继发性损伤PMID:期刊:AACN clinical issues in critical care nursing PubMed日期:1992-02[中文摘要] 脊髓损伤对患者具有毁灭性打击，同时在医疗费用、工资损失和独立性丧失方面也代价高昂。脊髓的初始损伤由多种损伤机制引起——屈曲、伸展、压缩、穿透、旋转以及疾病过程。当脊髓受损且神经组织发生坏死时，该组织不会再生。与周围神经系统可能再生不同，脊髓和大脑一样，属于中枢神经系统的一部分。脊髓从颅底延伸至L1椎体：颈段支配膈肌和手臂肌肉；胸段支配胸部和腹部肌肉；腰段和骶段支配腿部肌肉。此外，骶段负责肠道、膀胱和性功能。损伤平面越高，功能丧失越严重，因为不仅损伤平面本身受到影响，其以下平面也受累。损伤的发生始于周围韧带、骨骼和肌肉的初始创伤，进而影响脊髓。脊髓完全横断性损伤可能导致功能完全丧失，而仅部分脊髓受损则可能导致部分功能丧失。目前尚无治疗方法能够逆转这种初始损伤，该损伤在受伤后数分钟内即造成不可逆的损害。继发性损伤在数小时内随损伤扩散而发生。治疗有助于预防这种继发性损伤。
[英文摘要] Spinal cord injury is devastating to the victim, as well as being costly in terms of medical expenses, lost wages, and lost independence. The initial damage to the spinal cord results from several mechanisms of injury--flexion, extension, compression, penetration, rotation, and the disease process. When the spinal cord is injured and there is necrosis of the nervous tissue, no regeneration of that tissue occurs. Unlike in the peripheral nervous system, where regeneration is possible, the spinal cord is part of the central nervous system, as is the brain. The spinal cord extends from the base of the skull to the L1 vertebrae: the cervical levels innervate the diaphragm and muscles of the arms; the thoracic levels innervate the muscles of the chest and abdomen; and the lumbar and sacral levels innervate the muscles of the legs. In addition, the sacral levels are responsible for bowel, bladder, and sexual function. The higher the level of injury, the more severe the loss of function because, not only is the level of injury affected, but also the levels below. Injury occurs by initial trauma to the surrounding ligaments, bones, and muscles, which then affect the spinal cord. There may be total loss of function with damage completely across the cord or partial loss of function with damage affecting only part of the cord. No current treatment can reverse this initial injury, which causes irreversible damage within minutes of injury. Secondary damage occurs as the injury spreads over several hours. Treatment can help prevent this secondary damage.
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37. Current barriers and ethical considerations for clinical implementation of epidural stimulation for functional improvement after spinal cord injury.
37. 当前脊髓损伤后用于功能改善的硬膜外刺激临床实施的障碍与伦理考量PMID:日期:2019-09-24[中文摘要] 确定目前脊髓损伤后为改善功能而临床实施硬膜外刺激的障碍，并强调适用于未来研究路径的伦理构架。对脊髓损伤医学医师的调查，2019年1月。美国各地脊髓损伤模型系统医院站点。脊髓损伤医学医师。不适用。医师所识别的当前硬膜外刺激临床实施障碍。调查应答率为54.6%（=42），大多数医师（61.9%）曾被脊髓损伤患者询问过硬膜外刺激。研究确定了当前临床实施的诸多障碍，包括需要更多疗效研究（92.9%）、缺乏关于刺激参数的明确指南（83.3%），以及无法识别哪些患者将获益（76.2%）。在当前已识别出临床实施的多重障碍的情况下，从均势这一伦理构架的角度来评估这项研究正变得越来越相关。解决这些障碍可能需要改变医师的期望以及研究人员开展这项工作的方法。
[英文摘要] : To determine current barriers for clinical implementation of epidural stimulation for functional improvement after spinal cord injury and highlight applicable ethical constructs to approach future research. : Survey of spinal cord injury medicine physicians, January 2019. : Spinal cord injury model systems hospital sites across the United States. : Spinal cord injury medicine physicians. : NA. : Physician-identified current barriers to clinical implementation of epidural stimulation. : The response rate for the survey was 54.6% ( = 42), with the majority of physicians (61.9%) having been asked by patients with spinal cord injuries about epidural stimulation. Numerous current barriers to clinical implementation were identified, including need for additional efficacy studies (92.9%), lack of clear guidelines on stimulation parameters (83.3%), and inability to identify which patients will benefit (76.2%). : With multiple barriers to clinical implementation currently identified, evaluating this research with an eye toward the ethical construct of equipoise is increasingly relevant. Addressing these barriers may require modifications in both physician expectations and how researchers approach this work.
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38. Upper limbs dysmetria caused by cervical spinal cord injury: a case report.
38. 颈段脊髓损伤导致的上肢辨距不良：一例病例报告PMID:日期:2009-09-24[中文摘要] 由脊髓损伤导致的上肢辨距不良非常罕见。我们将在文章中讨论其相关机制。一名51岁男性在意外跌倒后突然出现双上肢无力、辨距不良及共济失调。脑磁共振成像（MRI）未见特异性表现。颈椎MRI显示C1脊髓病变及C4-6椎间盘突出压迫脊髓。经手术干预后症状缓解。突然出现的上肢辨距不良是小脑及其相关通路功能障碍的体征。然而，脊髓病变也可引起小脑体征，如辨距不良。
[英文摘要] Upper limbs dysmetria caused by spinal cord injury is very rare. We will discuss the associated mechanism in our articles. A 51-year-old male had sudden onset of weakness, dysmetria over bilateral upper limbs and ataxia after he fell accidentally. Brain magnetic resonance imaging (MRI) revealed no specific findings. C-spine MRI revealed C1 myelopathy and C4-6 spinal cord compression by bulged disc. The symptoms subsided after surgical intervention. Sudden onset of upper limbs dysmetria is a sign of dysfunction in cerebellum and its associated pathway. However, lesion in spinal cord can also cause cerebellar signs such as dysmetria.
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39. MiRNAs as Promising Translational Strategies for Neuronal Repair and Regeneration in Spinal Cord Injury.
39. miRNA作为脊髓损伤神经元修复与再生的有前景的转化策略PMID:日期:2022-07-12[中文摘要] 脊髓损伤（SCI）是对中枢神经系统（CNS）的一种毁灭性损伤，可导致SCI患者运动能力和感觉功能受损。SCI的特征包括神经炎症、轴突变性、神经元丢失和反应性胶质增生。目前的治疗策略，包括干细胞移植，尚未实现成功的临床治疗。miRNA在中枢神经系统发育过程中神经细胞类型的分化以及包括SCI在内的神经损伤后的病理过程中至关重要。这使其成为该病症治疗的理想候选者。事实上，多项研究已证明在中枢神经系统损伤中差异表达的miRNA参与其中。在此背景下，本综述的目的是概述评估miRNA疗法用于SCI的临床前证据。具体而言，我们将注意力集中在与神经元和轴突再生广泛相关的miRNA上。“miRNA替代疗法”旨在将miRNA递送至病变细胞并提高其在细胞中的靶向效率，这一新的治疗工具可能为促进SCI修复和减少功能缺损提供一种有前景的技术。
[英文摘要] Spinal cord injury (SCI) represents a devastating injury to the central nervous system (CNS) that is responsible for impaired mobility and sensory function in SCI patients. The hallmarks of SCI include neuroinflammation, axonal degeneration, neuronal loss, and reactive gliosis. Current strategies, including stem cell transplantation, have not led to successful clinical therapy. MiRNAs are crucial for the differentiation of neural cell types during CNS development, as well as for pathological processes after neural injury including SCI. This makes them ideal candidates for therapy in this condition. Indeed, several studies have demonstrated the involvement of miRNAs that are expressed differently in CNS injury. In this context, the purpose of the review is to provide an overview of the pre-clinical evidence evaluating the use of miRNA therapy in SCI. Specifically, we have focused our attention on miRNAs that are widely associated with neuronal and axon regeneration. "MiRNA replacement therapy" aims to transfer miRNAs to diseased cells and improve targeting efficacy in the cells, and this new therapeutic tool could provide a promising technique to promote SCI repair and reduce functional deficits.
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40. Medical management of spinal cord injury.
40. 脊髓损伤的内科管理PMID:日期:1985-02[中文摘要] 每年约有12000名美国人因脊髓损伤而致截瘫或四肢瘫。这些损伤大多源于机动车事故、跌倒和运动相关创伤。尽管近年来截瘫和四肢瘫患者的短期及长期预后已有所改善，但仍有数量惊人多的此类患者在初次住院前或住院期间死亡。以下文章旨在帮助临床医生理解并管理脊髓损伤患者。文章回顾了脊髓创伤的病理生理学，尤其是涉及颈段者，并从重症监护而非神经外科的角度讨论了该病的治疗。
[英文摘要] Each year, some 12,000 Americans are rendered paraplegic or quadriplegic by spinal cord injury. Most of these injuries result from motor vehicle accidents, falls, and sports-related trauma. Although the short-term and long-term prognosis for paraplegic and quadriplegic patients has improved in recent years, an alarmingly large number of these patients die before or during initial hospitalization. The following article has been prepared to help clinicians understand and manage patients with spinal cord injuries. It reviews the pathophysiology of spinal cord trauma, especially that involving the cervical region, and discusses the treatment of this condition from a critical care, rather than a neurosurgical, point of view.