CAJ | 학술논문

目的：分析胸腰椎体骨折合并脊髓损伤患者的生存状况及其危险因素。方法选择2010年1月—2013年10月诊断为胸腰椎骨折合并脊髓损伤的80例患者作为研究对象，随访1年分析患者生存状况，并根据患者生存状况分为预后良好组（56例）与预后差组（24例），采用回顾性方法记录相关信息，筛选出影响该类患者生存状况的相关因素，并用Logistic回归分析进行多因素回归分析危险因素。结果治疗后患者均未出现脊髓损伤恶化表现，随访1年24例（30？．0％）患者未达到预后良好标准。治疗后预后良好组患者脊柱后突Cobb＇s角、椎体前缘及后缘高度的压缩率均较预后差组患者低，差异有统计学意义（ P ＜0．05）。年龄、病程、椎管侵占率及使用激素与胸腰椎骨折合并脊髓损伤患者生存状况存在相关性，差异有统计学意义（ P ＜0．05）；多因素回归分析发现年龄≥60岁、病程≥7 d、椎管侵占率＞50．0％是胸腰椎骨折合并脊髓损伤患者生存状况差的独立危险因素，即时使用激素是胸腰椎骨折合并脊髓损伤患者生存状况差的保护因素（ P ＜0．05）。结论高龄、病程长、椎管侵占率大是胸腰椎骨折合并脊髓损伤患者预后差的独立危险因素，临床上早期规律使用激素可有效改善脊髓损伤患者术后脊髓功能预后。
목적：분석흉요추체골절합병척수손상환자적생존상황급기위험인소。방법선택2010년1월—2013년10월진단위흉요추골절합병척수손상적80례환자작위연구대상，수방1년분석환자생존상황，병근거환자생존상황분위예후량호조（56례）여예후차조（24례），채용회고성방법기록상관신식，사선출영향해류환자생존상황적상관인소，병용Logistic회귀분석진행다인소회귀분석위험인소。결과치료후환자균미출현척수손상악화표현，수방1년24례（30？．0％）환자미체도예후량호표준。치료후예후량호조환자척주후돌Cobb＇s각、추체전연급후연고도적압축솔균교예후차조환자저，차이유통계학의의（ P ＜0．05）。년령、병정、추관침점솔급사용격소여흉요추골절합병척수손상환자생존상황존재상관성，차이유통계학의의（ P ＜0．05）；다인소회귀분석발현년령≥60세、병정≥7 d、추관침점솔＞50．0％시흉요추골절합병척수손상환자생존상황차적독립위험인소，즉시사용격소시흉요추골절합병척수손상환자생존상황차적보호인소（ P ＜0．05）。결론고령、병정장、추관침점솔대시흉요추골절합병척수손상환자예후차적독립위험인소，림상상조기규률사용격소가유효개선척수손상환자술후척수공능예후。
Objective To investigate the survival status of patients with thoracolumbar vertebral body fracture com -bined with spinal cord injury , and to analyze its risk factors .Methods From January 2010 to October 2013 , 80 patients with thoracolumbar fractures combined with spinal cord injury were selected as the research object .The patients were followed up for 1 year.The patients were divided into good prognosis group (56 cases) and poor prognosis group (24 cases).The related factors of influencing the survival status of the patients were selected by the retrospective method , and the risk factors were an-alyzed by Logistic regression analysis .Results After treatment , there was no deterioration of spinal cord injury , and 24 cases (30.0%) were not reached the good prognosis standard after followed up for 1 year.After treatment, the good prognosis group’s spine Cobb's angle, vertebral anterior and posterior height ’s compression ratio was lower compared with the poor prog-nosis group.The difference was statistically significant ( P <0.05).Age, course of disease, spinal canal encroachment rate and the use of hormone and thoracolumbar fractures combined with spinal cord injury patients ’ living conditions existed corre-lation, the difference was statistically significant ( P <0.05);multi factor regression analysis showed that age is more than or equal to 60 years, course of disease is more than or equal to 7 days, spinal canal occupation rate >50.0%is the poor inde-pendent risk factors for survival status of patients with thoracolumbar vertebral fracture combined with spinal cord injury , the immediate use of the hormone is protection factors for survival status of patients with thoracolumbar fractures combined with spinal cord injury ( P <0.05).Conclusion Elderly patients with advanced disease , and spinal canal occupation rate are the independent risk factors for poor prognosis of thoracolumbar fractures combined with spinal cord injury , and early clinical use of hormone can effectively improve the prognosis of spinal cord injury in patients with spinal cord injury .