共识与指南
ENGLISH ABSTRACT
创伤性脊柱脊髓损伤康复治疗专家共识(2020版)
曹烈虎
牛丰
张文财
杨强
陈世杰
杨国庆
王博禹
陈雁西
刘国辉
王栋梁
刘曦明
童晓玲
刘国栋
刘宏建
罗涛
施忠民
黄标通
陈文明
王启宁
宋绍军
杨立利
刘同生
何大为
余正红
张建政
侯志勇
邵增务
张殿英
林浩东
禹宝庆
陈云丰
朱晓东
韩庆林
顾峥嵘
陈晓
胡衍
熊蠡茗
张云飞
王勇
张磊
杨雷
童培建
贾金鹏
张鹏
张勇
孙廓
沈涛
董世武
王剑飞
王宏亮
冯勇
应志敏
胡成栋
李明
陈晓涛
杨伟国
吴兴
周家钤
徐海栋
米博斌
张英泽
苏佳灿
作者及单位信息
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DOI: 10.3760/cma.j.issn.1001-8050.2020.05.001
Expert consensus on rehabilitation strategies for traumatic spinal cord injury
Cao Liehu
Niu Feng
Zhang Wencai
Yang Qiang
Chen Shijie
Yang Guoqing
Wang Boyu
Chen Yanxi
Liu Guohui
Wang Dongliang
Liu Ximing
Tong Xiaoling
Liu Guodong
Liu Hongjian
Luo Tao
Shi Zhongmin
Huang Biaotong
Chen Wenming
Wang Qining
Song Shaojun
Yang Lili
Liu Tongsheng
He Dawei
Yu Zhenghong
Zhang Jianzheng
Hou Zhiyong
Shao Zengwu
Zhang Dianying
Lin Haodong
Yu Baoqing
Chen Yunfeng
Zhu Xiaodong
Hang Qinglin
Gu Zhengrong
Chen Xiao
Hu Yan
Xiong Liming
Zhang Yunfei
Wang Yong
Zhang Lei
Yang Lei
Tong Peijian
Jia Jinpeng
Zhang Peng
Zhang Yong
Sun Kuo
Shen Tao
Dong Shiwu
Wang Jianfei
Wang Hongliang
Feng Yong
Ying Zhimin
Hu Chengdong
Li Ming
Chen Xiaotao
Yang Weiguo
Wu Xing
Zhou Jiaqian
Xu Haidong
Mi Bobin
Zhang Yingze
Su Jiacan
Authors Info & Affiliations
Cao Liehu
Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China; Luodian Hospital, Baoshan District, Shanghai 201908, China
Niu Feng
First Hospital of Bethune Affiliated to Jilin University, Changchun 130021, China
Zhang Wencai
First Affiliated Hospital of Jinan University, Guangzhou 510632, China
Yang Qiang
Tianjin Hospital, Tianjin 300210, China
Chen Shijie
Third Hospital of Xiangya Affiliated to Zhongnan University, Changsha 410013, China
Yang Guoqing
Zhongye Hospital, Shanghai 200941, China
Wang Boyu
Zhongye Hospital, Shanghai 200941, China
Chen Yanxi
Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
Liu Guohui
Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science Technique, Wuhan 430000, China
Wang Dongliang
Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
Liu Ximing
General Hospital of Central Theater, Wuhan 430000, China
Tong Xiaoling
Hankou Hospital, General Hospital of the Central Theater, Wuhan 430000, China
Liu Guodong
Institute of Field Surgery, Daping Hospital Affiliated to Army Military Medical University, Chongqing 400042, China
Liu Hongjian
First Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
Luo Tao
Shanghai Public Health Clinical Center, Shanghai 200083, China
Shi Zhongmin
Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
Huang Biaotong
Institute of Translational Medicine, Shanghai University, Shanghai 200444, China
Chen Wenming
Institute of Engineering And Applied Technology, Fudan University, Shanghai 200433, China
Wang Qining
Engineering Institute of Peking University, Beijing 100871, China
Song Shaojun
General Hospital of the Central Theater, Wuhan 430000, China
Yang Lili
Changzhen Hospital Affiliated to Naval Medical University, Shanghai 200433, China
Liu Tongsheng
Luodian Hospital, Baoshan District, Shanghai 201908, China
He Dawei
Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China
Yu Zhenghong
People's Hospital of Henan, Zhengzhou 450003, China
Zhang Jianzheng
Seventh Medical Center of PLA General Hospital, Beijing 100700, China
Hou Zhiyong
Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
Shao Zengwu
Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science Technique, Wuhan 430000, China
Zhang Dianying
People's Hospital of Peking University, Beijing 100044, China
Lin Haodong
First Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200800, China
Yu Baoqing
Pudong Hospital Affiliated to Fudan University, Shanghai 200433, China
Chen Yunfeng
General Hospital of Central Theater, Wuhan 430000, China
Zhu Xiaodong
Shanghai Tongren Hospital, Shanghai 200050, China
Hang Qinglin
Hospital Affiliated to Nantong University, Nantong 226001, China
Gu Zhengrong
Luodian Hospital, Baoshan District, Shanghai 201908, China
Chen Xiao
Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China
Hu Yan
Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China
Xiong Liming
Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science Technique, Wuhan 430000, China
Zhang Yunfei
Tangdu Hospital Affiliated to Air Force Military Medical University, Xi'an 710038, China
Wang Yong
Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou 325003, China
Zhang Lei
Putuo District Central Hospital Affiliated to Shanghai University of Chinese Medicine, Shanghai 200062, China
Yang Lei
Second Hospital Affiliated to Wenzhou Medical University, Wenzhou 325003, China
Tong Peijian
Traditional Chinese Hospital, Hangzhou 310006, China
Jia Jinpeng
PLA General Hospital, Beijing 100039, China
Zhang Peng
Shandong Provincial Hospital, Jinan 250021, China
Zhang Yong
Tangdu Hospital Affiliated to Air Force Military Medical University, Xi'an 710038, China
Sun Kuo
Second Hospital Affiliated to Nanchang University, Nanchang 330006, China
Shen Tao
Shengjing Hospital Affiliated to Chinese Medical University, Shenyang 117004, China
Dong Shiwu
Department of Biomedical Engineering and Imaging Medicine of Army Medical University, Chongqing 400038, China
Wang Jianfei
Hospital Affiliated to Yan'an University Yan'an 716000, China
Wang Hongliang
People's Hospital of Fuyang, Fuyang 100191, China
Feng Yong
Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science Technique, Wuhan 430000, China
Ying Zhimin
Second Hospital Affiliated to Medical College of Zhejiang University, Hangzhou 310058, China
Hu Chengdong
Central Hospital of Handan, Handan 130403, China
Li Ming
Sixth Hospital of Ningbo, Ningbo 315040, China
Chen Xiaotao
People's Hospital of Qinghai, Xining 810007, China
Yang Weiguo
Medical College of Hongkong, Hongkong 999077, China
Wu Xing
Tenth Hospital Affiliated to Tongji University, Shanghai 200072, China
Zhou Jiaqian
Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China
Xu Haidong
Nanjing General Hospital of PLA Nanjing Military District, Nanjing 210002, China
Mi Bobin
Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science Technique, Wuhan 430000, China
Zhang Yingze
Institute of Engineering And Applied Technology, Fudan University, Shanghai 200433, China
Su Jiacan
Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China
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DOI: 10.3760/cma.j.issn.1001-8050.2020.05.001
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摘要

创伤性脊柱脊髓损伤(TSCI)患者由于运动感觉功能障碍,导致多种并发症而危及生命,患者的生存质量受到严重影响。本共识在TSCI流行病学的基础上,总结国内外文献和调研结果,对TSCI的损伤分级、康复评定、康复策略和主要康复措施等方面进行归纳和总结,期望对TSCI的康复治疗提供早期合理规范的治疗方案。

脊柱损伤;脊髓损伤;康复;指南
ABSTRACT

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Spinal injuries;Spinal cord injuries;Rehabiltitaion;Guidelines
Su Jiacan, Email: mocdef.3ab61naciajusrd, Tel: 0086-21-31161699
引用本文

曹烈虎,牛丰,张文财,等. 创伤性脊柱脊髓损伤康复治疗专家共识(2020版)[J]. 中华创伤杂志,2020,36(05):385-392.

DOI:10.3760/cma.j.issn.1001-8050.2020.05.001

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*以上评分为匿名评价
创伤性脊柱脊髓损伤(traumatic spinal cord injury,TSCI)是骨科医师所面临的临床难题之一,原因在于患者的脊柱结构稳定性破坏,脊髓遭受严重受损导致患者的运动、感觉、大小便功能障碍,致残率高 [ 1 ]。TSCI发生率达236~4 187/100万;其中,中国TSCI年患病率为23.7~60.6/100万 [ 2 , 3 ],澳大利亚为370~681/100万,欧洲地区为280~316/100万,北美地区为721~4 187/100万 [ 4 ]。由此可见,我国TSCI患病率稍低均低于世界平均患病率。全球TSCI患者的年龄为18~32岁,这是发生TSCI的主要人群,主要因为该年龄段是社会中最活跃、最具社会生产力的人群。从发病部位分析,颈髓TSCI最为常见,占所有TSCI的55%~75% [ 5 , 6 ],其次为胸髓、腰髓。交通事故和高处坠落是TSCI的主要致伤原因 [ 7 ]。随着年轻人从事高危工作与极限运动增多,相关的TSCI也随之发生 [ 8 , 9 ]。如果不能有效促进肢体功能的康复,将导致压疮、尿路感染、肾功能衰竭等并发症而危及生命。因此,TSCI的康复治疗显得尤为重要。早期准确、合理、规范的康复治疗可以有效提高治愈率、降低致残率、恢复肢体功能、改善患者生存质量 [ 1 ]。为进一步规范TSCI康复治疗、促进脊柱脊髓损伤术后康复,中国医师协会急救复苏专业委员会创伤骨科与多发伤学组召集国内相关研究领域的专家,结合国内外最新的循证医学证据和临床经验,撰写了本共识。本共识从TSCI的损伤分级、康复评定、康复策略及主要康复措施等方面提出专家推荐意见,为TSCI患者的早期处理提供标准规范,以提升其治疗效果,改善患者预后。
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备注信息
A
苏佳灿,Email: mocdef.3ab61nacaijusrd,电话:021-31161699
B

所有作者参与论文撰写;曹烈虎、陈雁西、王栋梁:论文修改;苏佳灿:研究设计、论文修改、经费支持

C

曹烈虎,牛丰,张文财,等.创伤性脊柱脊髓损伤康复治疗专家共识(2020版)[J].中华创伤杂志,2019, 35(5):385-392. DOI:10.3760/cma.j.issn.1001-8050.2020.05.001.

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所有作者声明不存在利益冲突
E
国家重点研发计划 (2018YFC2001500)
国家自然科学基金重大研究计划项目 (91749204)
国家自然科学基金 (81771491)
上海市卫生系统优秀学科带头人计划 (2017BR011)
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