Update on traumatic acute spinal cord injury. Part 1
Update on traumatic acute spinal cord injury. Part 1
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DOI：
10.1016/j.medin.2016.11.002
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发表时间：
2017-05-01
影响因子：
3
通讯作者：
Salvador de la Barrera, S.
中科院分区：
文献类型：
--
作者：
Galeiras Vazquez, R.;Ferreiro Velasco, M. E.;Salvador de la Barrera, S.
创伤性脊髓损伤需要采用多学科方法来进行急性期的专门治疗和处理继发性并发症。怀疑或诊断脊髓损伤是正确处理的第一步。对脊髓损伤的院前处理和急性期特点进行回顾。早期选择性插管的呼吸监测、正确识别和治疗神经源性休克对于预防继发性脊髓损伤至关重要。皮质类固醇的使用目前还不是神经保护治疗的标准做法，而血流动力学监测和早期手术减压是充分治疗的基石。创伤性脊髓损伤通常是多发性创伤的一部分，这会使诊断变得困难。神经系统检查和正确选择放射学检查可以防止脊髓损伤的延迟诊断，并有助于确定预后。 (C) 2016 爱思唯尔西班牙公司，S.L.U. y SEMICYUC。版权所有。
Traumatic spinal cord injury requires a multidisciplinary approach both for specialized treatment of the acute phase and for dealing with the secondary complications. A suspicion or diagnosis of spinal cord injury is the first step for a correct management.A review is made of the prehospital management and characteristics of the acute phase of spinal cord injury. Respiratory monitoring for early selective intubation, proper identification and treatment of neurogenic shock are essential for the prevention of secondary spinal cord injury.The use of corticosteroids is currently not a standard practice in neuroprotective treatment, and hemodynamic monitoring and early surgical decompression constitute the cornerstones of adequate management.Traumatic spinal cord injury usually occurs as part of multiple trauma, and this can make diagnosis difficult. Neurological examination and correct selection of radiological exams prevent delayed diagnosis of spinal cord injuries, and help to establish the prognosis. (C) 2016 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.