Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury_West China Medical Journal

Authors：

 DUZhi-po , ZHAOHong-wei , GAOJian-gang , ZHANGJing-bin

Department of Spine Surgery, the People's Hospital of Tang County, Tang County, Heibei 072350, P. R. China;

Corresponding author：

Keywords：

Cervical spinal cord injury; Evidence-based treatment; Practical strategies; Case report; Clinical result

DOI：

10.7507/1002-0179.20140274

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Objective To explore the practice of the evidence-based treatment strategy for cervical spinal cord injury. Methods One patient with cervical spinal cord injury was admitted to our hospital on January 3, 2013. We obtained medical evidences by searching databases and regulated the best treatment after evaluating the patient's comprehensive conditions. And then, the whole treatment strategy was fully implemented. Finally, the consequent results were evaluated. Results The evidence-based medicine showed that the therapeutic targets were to save the residual function, prevent complications, and promote the recovery of neural function. Based on the real-time conditions of patient, we developed and practiced the evidence-based comprehensive rehabilitation programs, including absolute rest in bed, high-dose steroids, neurotrophic drugs, Chinese medicine rehabilitation and prevention of complications. After a follow-up of half a year, the patient obtained a good curative effect. The patient was saved from paralyzing. Moreover, the patient restored the capacity of standing, walking and a certain level of self-care ability. Conclusion For the cervical spinal cord injury, treatment decision based on evidence-based medicine is more scientific, and it can ensure maximum benefit for the patients. Therefore, it is worthy of popularizing.

Citation： DUZhi-po, ZHAOHong-wei, GAOJian-gang, ZHANGJing-bin. Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury. West China Medical Journal, 2014, 29(5): 904-906. doi: 10.7507/1002-0179.20140274 Copy

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13.	杨清芬, 黄绍梅, 邱薇. 穴位针刺治疗小儿结核性脑膜炎后面瘫、肢体瘫痪30例临床观察[J]. 现代医院, 2009, 9(4):68-69.
14.	林琳, 牛秀连. 针灸为主治疗小儿脑瘫语言障碍的临床研究[J]. 国际中医中药杂志, 2008, 30(2):144-145.
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1. Diaz-Ruiz A, Alcaraz-Zubeldia M, Maldonado V, et al. Differential time-course of the increase of antioxidant thiol-defenses in the acute phase after spinal cord injury in rats[J]. Neurosci Lett, 2009, 452(1):56-59.
2. Sharma HS. Pathophysiology of blood-spinal cord barrier in traumatic injury and repair[J]. Curr Pharm Des, 2005, 11(11):1353-1389.
3. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 3版. 北京:人民军医出版社, 2009:534-579.
4. 刘智, 孙天胜, 李京生, 等. 早期手术治疗急性颈脊髓损伤[J]. 中华创伤骨科杂志, 2004, 1(11):10-12.
5. Bracken MB. Steroids for acute spinal cord injury[J]. Cochrane Database Syst Rev, 200, (3):CD001046.
6. Petitjean ME, Pointillart V, Dixmerias F, et al. Medical treatment of spinal cord injury in the acute stage[J]. Ann Fr Anesth Reanim, 1998, 17(2):114-122.
7. 邱有波, 袁梦郎, 杨拯, 等. 硫酸镁联合单唾液酸神经节苷脂对脊髓损伤大鼠运动功能恢复的影响[J]. 中国康复理论与实践, 2011, 17(2):137-140.
8. 王丽娜, 刘芳, 张伟玲, 等. 神经节苷脂对大鼠急性脊髓损伤后bcl-2 mRNA表达的影响[J]. 中国急救医学, 2006, 26(9):680-681.
9. Gorria M, Huc L, Sergent O, et al. Protective effect of monosialoganglioside GM1 against chemically induced apoptosis through targeting of mitochondrial function and Iron transport[J]. Biochem Pharmacol, 2006, 72(10):1343-1353.
10. 张强, 邹德威. 脑源性神经营养因子转基因细胞移植和神经节苷脂对大鼠脊髓损伤N-甲基-D-天门冬氨酸受体的影响[J]. 中华创伤骨科杂志, 2006, 8(2):162-164.
11. 李花, 陈安, 李亮, 等. 三七总皂苷对大鼠脊髓损伤后GS的表达及运动功能恢复的影响[J]. 湖南中医药大学学报, 2012, 32(1):23-26, 30.
12. 曹中华, 王金光. 脊髓损伤治疗进展[J]. 海南医学, 2012, 23(6):123-128.
13. 杨清芬, 黄绍梅, 邱薇. 穴位针刺治疗小儿结核性脑膜炎后面瘫、肢体瘫痪30例临床观察[J]. 现代医院, 2009, 9(4):68-69.
14. 林琳, 牛秀连. 针灸为主治疗小儿脑瘫语言障碍的临床研究[J]. 国际中医中药杂志, 2008, 30(2):144-145.
15. Dooling E, Winkelman C. Hyponatremia in the patient with subarachnoid hemorrhage[J]. Neurosci Nurs, 2004, 36(3):130-135.
16. Amini A, Schmidt MH. Syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia after spinal surgery[J]. Neurosurg Focus, 2004, 16(4):E10.
17. Engoren M, Arslanian EC, Fenn BN. Hospital and long-term outcome after tracheostomy for respiratory failure[J]. Chest, 2004, 125(1):220-227.
18. 王波, 孙平, 陈飞翔. 颈椎损伤后高位截瘫合并呼吸衰竭28例救治体会[J]. 人民军医, 2007, 50(3):154.

West China Medical Journal

Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury

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