摘要
目的 探讨急性创伤性脊髓损伤(TSCI)后功能恢复的早期临床预测因素.方法 纳入2019年1月至2021年12月在该院接受手术治疗的131例TSCI患者作为研究对象,收集患者性别、年龄、体质量指数(BMI)、吸烟状况、合并症、脊髓损伤水平、损伤能量、损伤机制、神经功能评估结果、住院指标、术后功能恢复等指标,采用Pearson相关性分析观察患者临床资料与术后1年时脊髓独立测量量表Ⅲ(SCIM-Ⅲ)得分的相关性,采用多元线性回归分析观察临床资料与术后1年时SCIM-Ⅲ评分的独立相关性.结果 随访期间失访12例,共有119例患者完成术后1年时SCIM-Ⅲ评分.SCIM-Ⅲ平均总分为(65.8±10.5)分.Pearson相关性分析显示,性别、压疮、坠积性肺炎、尿路感染与术后1年时SCIM-Ⅲ评分不存在相关性(P＞0.05);年龄、BMI、吸烟、糖尿病、高血压、心血管疾病、呼吸系统疾病、至少1种合并症、损伤能量、受伤至治疗时间、住院时间、至少1种并发症与术后1年时的SCIM-Ⅲ评分呈显著负相关(P＜0.05);脊髓损伤水平、治疗策略、ASIA量表、AMS评分与术后1年时SCIM-Ⅲ评分呈显著正相关(P＜0.05).多元线性回归分析显示,年龄、BMI、至少1种合并症、至少1种并发症、受伤至治疗时间≥24 h与术后1年时SCIM-Ⅲ评分呈显著负相关(P＜0.05);ASIA量表和AMS评分与术后1年时SCIM-Ⅲ评分呈显著正相关(P＜0.05).结论 TSCI急性期患者住院期间的年龄、BMI、合并症、并发症、受伤至手术时间、ASIA和AMS与患者术后1年内的功能恢复相关;评估TSCI患者住院期间的临床状态,有助于了解患者的脊髓功能恢复潜力.
Abstract
Objective To explore the early clinical predictors of functional recovery after acute traumatic spinal cord injury(TS-CI).Methods A total of 131 TSCI patients who underwent surgical treatment in our hospital from January 2019 to December 2021 were included as the study subjects.The patient's gender,age,body mass index(BMI),smoking status,concomitant diseases,spi-nal injury level,injury energy,injury mechanism,neurological injury level,neurological function evaluation results,hospitalization in-dicators and postoperative functional recovery were collected.Pearson correlation was used to observe the correlation between clinical data and the spinal cord independent measurement scale Ⅲ(SCIM Ⅲ)at 1 year after surgery,and multiple linear regression was used to observe the independent correlation between clinical data and SCIM Ⅲ at 1 year after surgery.Results During the follow-up peri-od,12 patients were lost,and a total of 119 patients completed the SCIM-Ⅲ score 1 year after surgery.The average total score of SCIM-Ⅲ was(65.8±10.5)points.Pearson correlation analysis showed that there was no correlation between gender,pressure ul-cers,precipitating pneumonia,and urinary tract infection and the 1-year SCIM Ⅱ score(P＞0.05).Age,body mass index,smoking,diabetes,hypertension,cardiovascular disease,respiratory system,at least one concomitant disease,injury energy,injury to treatment time,hospital stay and at least one complication were significantly negatively correlated with SCIM-Ⅲ 1 year after surgery(P＜0.05),and spinal injury level,treatment strategy,ASIA scale,and AMS score were significantly positively correlated with SCIM-Ⅲ score 1 year after surgery(P＜0.05).Multiple linear regression results showed that age,BMI,at least one concomitant disease,at least one complication,and time from injury to treatment≥24 hours were significantly negatively correlated with the 1-year SCIM-Ⅲ score(P＜0.05),while ASIA and AMS were significantly positively correlated with the 1-year SCIM-Ⅲ score(P＜0.05).Conclusion Age,BMI,concomitant diseases,complications,time from injury to treatment,ASIA,and AMS during the acute phase of TSCI hospi-talization are associated with functional recovery within 1 year.Assessing the clinical status during the acute phase of TSCI hospitalization is helpful in understanding the potential for functional recovery of patients.
维普
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