华西医学

华西医学

脊髓损伤的临床康复进展

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脊髓损伤严重损害患者的生活质量、功能状态和社会独立性。自上世纪以来,对脊髓损伤进行的一系列基础研究,使人们对其具体的损伤及修复机制、疾病病理生理学有了深刻认识。但到目前为止,如何修复脊髓损伤后受损的神经功能仍是神经病学上的一个难题,围绕某些治疗脊髓损伤的治疗策略仍然存在争议,包括 MRI、抗凝预防的类型和时间、手术干预的最佳时机、皮质类固醇如甲泼尼龙琥珀酸钠的使用,以及康复的类型和时间。目前对于脊髓损伤患者来说,早期外科干预以及神经保护治疗可能是最好的治疗方式,与此同时,康复介入及心理干预同样重要。

Spinal cord injuries (SCI) seriously impair the quality of life, functional status, and social independence of the patients. Since the last century, a series of basic research on spinal cord injury has made us a deep understanding of its mechanisms and pathophysiology. But so far, how to repair damaged nerve functions after SCI is still a neurological problem. There are still controversies surrounding some treatment strategies for SCI, including the use of magnetic resonance imaging, type and timing of anticoagulant prevention, the timing of surgical intervention, the use of corticosteroids such as methylprednisolone sodium, as well as the type and timing of rehabilitation. For patients with SCI, early surgical intervention and neuroprotective therapy may be the best treatment. At the same time, rehabilitation and psychological intervention are equally important.

关键词: 脊髓损伤; 手术干预; 康复

Key words: Spinal cord injury; Surgical intervention; Rehabilitation

引用本文: 杨云, 许光旭. 脊髓损伤的临床康复进展. 华西医学, 2018, 33(10): 1303-1310. doi: 10.7507/1002-0179.201805048 复制

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