胸脊髓损伤:管理,技术,时间
Marko Jug1, Radko Komadina2, Klaus Wendt3
1University Medical Centre Ljubljana, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. marko.jug@kclj.si.
概括
早期的手术减压可以改善急性创伤性脊髓损伤 (tSCI) 的结果,特别是不完整的损伤. 然而,在决定手术干预的最佳时间之前,仔细评估患者至关重要.
科学领域:
- 神经外科 神经外科
- 创伤学 创伤学 创伤学
- 神经学 神经学
背景情况:
- 急性创伤性脊髓损伤 (tSCI) 是一种复杂的疾病,结果各不相同.
- 影响神经学结果的因素包括损伤水平,严重程度,压缩和血压管理.
研究的目的:
- 审查目前对影响STSCI神经学结果的因素的理解.
- 讨论SCI患者手术减压的最佳时间和方法.
主要方法:
- 对手术减压和脊柱固定在胸部和胸脊柱SCI的研究的文献综述.
- 分析影响神经恢复的因素,包括手术时间和血液动力学管理.
主要成果:
- 早期的手术减压可能有利于不完整的sci,但严重的伤害可能无法挽救.
- 最佳的手术时间要求对个体患者的恢复潜力进行批判性评估.
- 建议进行血液动力学稳定和最少侵入性的方法.
结论:
- 在SCI中,手术减压的时间必须根据受伤的严重程度和患者的病情进行个性化.
- 保持足够的平均动脉压 (MAP) 和预防二次侮辱是非常重要的.
- 高剂量甲基prednisolone糖酸盐 (MPSS) 的作用仍然存在争议,但可以考虑.
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