目的 探讨身痛逐瘀汤加减方联合腰椎牵引疗法治疗急性期腰椎间盘突出症(LDH)的临床疗效.方法 将114例急性期LDH患者按随机数字表法分为观察组与对照组各57例,对照组给予腰椎牵引,观察组在对照组基础上给予身痛逐瘀汤加减方;7 d为1个疗程,共3个疗程.结果 与本组治疗前相比,两组中医证候评分、镇痛效果、运动功能评价均有所改善(P＜0.05或P＜0.01),且观察组改善更为显著(P＜0.05).在临床疗效中总好转与临床症状恢复时间的比较上,观察组的提升更为明显(P＜0.05).结论 采用身痛逐瘀汤加减方联合腰椎牵引疗法治疗急性期LDH的临床疗效显著,且能够有效改善患者急性期的疼痛状态.

Objective:To investigate the risk factors of lower extremity venous thrombosis in elderly patients with femoral neck fracture during perioperative period after artificial bipolar femoral head replacement and the effect of Mailuoshutong in clinical prevention and treatment of thrombosis.Methods:A retrospective case-control study was conducted on the clinical data of 92 elderly patients with femoral neck fracture who were admitted to the Affiliated Hospital of North China University of Technology from January 2015 to January 2020.According to the treatment method, the patients were divided into an observation group (44 cases) and a control group (48 cases). Patients in the observation group were treated with the combination of Mailuoshutong Pill and low molecular weight heparin calcium.The control group was treated with low molecular weight heparin calcium.The patients in both groups started anti-coagulation therapy immediately after admission, and they stopped the drug one day before operation and continued to take the drug on the second day after operation.Venous ultrasound of both lower limbs was recorded at the time of admission, on the 7th day after admission, and 14 days after surgery.The changes in hemoglobin, red blood cell count and drainage volume before and after operation were recorded.Results:The incidence of thrombosis was 2 cases (4.54%) on the 7th day after admission in the observation group and 9 cases (18.75%) in the control group.The difference was statistically significant (χ 2=4.400, P=0.036). The incidence of thrombosis was 3 cases (6.82%) in the observation group and 11 cases (22.92%) in the control group 14 days after operation.The difference was statistically significant(χ 2=4.611, P=0.032). The hemoglobin changes of observation group and control group were (23.73±6.89) g/L and (22.10±5.18) g/L respectively on the first day before operation and 48 hours after operation.The red blood cell count changes were (0.67±0.32) × 1012/L and (0.56±0.36) × 1012/L respectively, and the drainage volume of drainage tube after operation was (100.27±23.73) ml and (102.40±20.90) ml, respectively.There was no significant difference in the above indexes between the two groups (all P>0.05). Multivariate Logistic regression analysis showed that only low molecular weight heparin calcium was used to prevent and treat thrombosis ( OR=10.281, 95% CI: 1.609-65.689, P=0.014); the elderly patients ( OR=1.190, 95% CI: 1.061-1.336, P=0.003) and the thrombosis at the time of admission ( OR=8.346, 95% CI: 1.773-39.281, P=0.007) were the risk factors for lower extremity venous thrombosis on the 14th day after surgery. Conclusion:Mailuoshutong pill combined with low molecular weight heparin calcium can safely and effectively treat lower extremity venous thrombosis in perioperative period of artificial femoral head replacement for femoral neck fracture in elderly patients.Mailuoshutong pill combined with low molecular weight heparin calcium was a protective factor for lower extremity venous thrombosis 14 d after operation, while advanced age and thrombosis at the time of admission were risk factors.

目的 探讨119例中老年人小转子处股骨与髓腔直径比值与骨密度的相关性,预测骨密度值及判断骨质疏松症的准确性.方法 华北理工大学附属医院2014年1月—2020年1月同时行骨盆正位片和骨密度检查的55岁以上中老年人119例.通过骨盆正位X线片,测量得到股骨小转子上缘、中点、下缘股骨直径与髓腔直径的比值.经双能X线骨密度测量仪测量腰椎及股骨颈骨密度.按T值≤-2.5标准差将其分为骨质疏松组40例与非骨.质疏松组79例.比较二组性别、年龄、体重指数.通过Pearson偏相关分析,揭示股骨髓腔直径比值与腰椎和股骨颈骨密度之间的相关性.通过一元线性方程分析股骨髓腔直径比值预测骨密度的准确性.通过接受者工作特征曲线(ROC)确定股骨髓腔直径比值诊断骨质疏松症的最佳值及准确率,预测的灵敏度和特异性.结果 骨质疏松组平均年龄(68.98±6.68)岁,男11例,占27.5％,女29例,占72.5％、小转子处股骨髓腔直径上缘、中点、下缘比值分别为(1.124±0.063)、(1.199±0.058)、(1.263±0.073);非骨质疏松组平均年龄(65.76±6.27)岁,男40例,占50.6％,女39例,49.4％,小转子处股骨髓腔直径上缘、中点、下缘比值分别为(1.187±0.073)、(1.324±0.086)、(1.385±0.074),二组比较,差异均有统计学意义(均P＜0.05).Pearson偏相关分析小转子处上缘、中点、下缘股骨髓腔直径比值与股骨颈骨密度的相关性结果分别为(r=0.173,PP=0.061)、(r=0.310,P=0.001)、(r=0.508,P=0.000),与腰椎骨密度相关性结果分别为(r=0.282,P=0.002)、(r=0.399,P=0.000)、(r=0.507,P=0.000).股骨颈骨密度和腰椎骨密度与小转子下缘股骨髓腔直径比拟合一元线性回归方程结果分别为(调整后R2=0.267,F=43.967,P=0.000),(调整后R2=0.264,F=43.260,P=0.000),方程均有统计学意义;小转子下缘股骨髓腔直径比值每增加0.01,股骨颈骨密度值增加0.00806 g/cm2,腰椎骨密度值增加0.00747 g/cm2.利用ROC曲线进行骨.质疏松症的诊断性分析得知曲线下面积AUC=0.884,预测准确率为63.6％,小转子下缘股骨髓腔比值为1.328,敏感度为0.886、特异度为0.750,以上差异均有统计学意义.结论 小转子下缘股骨髓腔直径比与骨密度呈正相关,通过小转子处股骨髓腔直径比值进行骨质疏松症的筛查具有一定准确性且方便快速,具有普及应用价值.

目的 通过腹腔注射醋酸去氨加压素(DDAVP)探讨建立大鼠膜迷路积水模型的可行性.方法 选取30只健康SD大鼠,随机分为正常组、对照组及实验组,不同时间节点分别给予不同剂量的DDAVP及生理盐水腹腔注射,17天后观察大鼠行为学变化,听觉脑干诱发电位(ABR)检测听力的变化,HE染色观察耳蜗形态结构的变化,耳蜗中阶(即蜗管)横截面积(SM)与中阶和前庭阶横截面积(SM+SV)之和的比值的变化.结果 实验组大鼠出现平衡障碍,ABRⅡ波阈值升高(P=0.000<0.05);且Ⅱ波(P=0.004<0.05)、Ⅴ波的潜伏期(P=0.000<0.05)及Ⅲ～Ⅴ波间期(P=0.006<0.05)明显延长.HE染色提示前庭膜向前庭阶膨隆或断裂,SM与SM+SV比值增大(P=0.000<0.05).结论 腹腔注射DDAVP可以诱导大鼠内耳膜迷路积水,成功建立膜迷路积水动物模型.

目的 探讨单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)及脂蛋白(a)[lipoprotein(a),LP(a)]与梅尼埃病的关系.方法 选取30只健康SD大鼠,分成正常组、对照组及实验组,每组10只,实验组腹腔注射醋酸去氨加压素(4μg·kg-1·d-1连续注射7 d后改为6μg·kg-1·d-1连续注射3 d)行膜迷路积水造模,对照组腹腔注射等量生理盐水,正常组不作处理,停药7 d后对三组动物行ABR检测,取耳蜗中阶横截面积(SM)/(中阶+前庭阶横截面积)(SM+SV)比值评价膜迷路积水情况.造模成功后通过免疫组化染色检测耳蜗组织中MCP-1的表达,通过酶联免疫吸附实验(ELISA)法检测血清中LP(a)的水平,对LP(a)水平与内耳积水程度及大鼠ABR各指标进行相关性分析.结果 实验组波 Ⅱ 阈值升高、波 Ⅱ 、Ⅴ 潜伏期及 Ⅲ-Ⅴ 波间期较正常组和对照组均延长,差异有统计学意义(P<0.05).实验组、对照组、正常组SM/(SM+SV)比值分别为0.45±0.04、0.34±0.02、0.35±0.01,前者显著大于后两者(P<0.05).实验组M C P-1在耳蜗螺旋器、血管纹螺旋韧带及神经节细胞组织表达明显,前庭膜上也有表达,其它两组无表达.实验组、对照组、正常组L P(a)水平分别为4.07±0.20、1.36±0.12、1.38±0.14 mg/L,前者显著高于后两者(P<0.001),LP(a)表达水平与膜迷路积水程度及ABR各指标间均呈正相关(P<0.001).结论 膜迷路积水模型大鼠耳蜗组织中MCP-1表达明显,血清LP(a)水平明显升高,且LP(a)水平与膜迷路积水程度及大鼠听力下降呈正相关,提示MCP-1和LP(a)可能与梅尼埃病的发生有关.

患者,男,66岁,因车祸致全身多发伤,右上肢疼痛、出血并完全性皮肤脱套4. 5 h于2020年5月30日入我院治疗.既往有高血压病史6年,冠心病史3年,未规律服药控制,吸烟饮酒史20 余年.查体:右上肢皮肤脱套伤,皮瓣呈桥状,范围由手腕至腋下,约占全身面积的6. 5％(见图1A).脱套皮瓣边缘存在碾挫伤,内部含有大量泥沙等异物,其血管、淋巴管及皮下组织同深筋膜肌肉层完全离断.肘关节周围肌肉组织挫伤较重,肘部及前臂肌腱、神经、血管组织外露并中度挫伤.肘关节囊开裂,可见关节软骨外露.右腕部尺桡动脉搏动可触及,右手感觉减退明显.X线检查未见明显骨折线.

目的 探讨封闭负压引流(VSD)后应用自制生肌玉红膏纱条换药治疗骶尾部Ⅳ期压疮伴感染的临床疗效.方法 收集我院2015年1月～2020年8月收治的骶尾部Ⅳ期压疮伴感染患者86例,按随机数字表法分三组:A组26例,单纯应用生肌玉红膏换药;B组27例,对创面清创后行VSD再采用西医换药治疗;C组33例,对骶尾部压疮清创后VSD,再采用生肌玉红膏换药.比较三组患者在入院时、治疗第10d、治疗第30d压力性溃疡治疗评估表(PUSH)分值变化及入院时和治疗第10d白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HBG)、血清白蛋白(ALB)、血清前白蛋白(PAB)、超敏C反应蛋白(CRP-C)、红细胞沉降率(ESR)变化.结果 入院时三组患者PUSH得分差异无统计学意义(P>0.05);治疗第30d时三组患者PUSH得分分别为(11.62±1.79)分、(14.07±1.27)分、(10.45±2.02)分,差异有统计学意义(F=32.669,P=0.000);其中C组恢复最好.入院时三组WBC、RBC、HGB、ALB、PAB、CRP-C、ESR差异无统计学意义(P>0.05),治疗第10d时上述指标组间比较差异有统计学意义(F=3.356、P=0.040,F=7.799、P=0.001,F=6.390、P=0.003,F=3.356、P=0.040,F=7.799、P=0.001,F=11.769、P=0.000,F=4.117、P=0.020),说明应用VSD治疗的B、C组指标优于A组.结论 VSD配合生肌玉红膏换药治疗骶尾部Ⅳ期压疮恢复快、患者一般状况好,值得临床推广.

Objective:To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation.Methods:Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation.Results:VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant ( t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm 2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm 2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation ( P<0.01). In the control group, there was significant difference between 14 days and 3 months ( P<0.01), and between 3 months and 6 months ( P<0.01); 6 months after operation, the difference was statistically significant ( P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation ( P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation ( P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age( OR=1.318, 95% CI1.002-1.732, P=0.048) and treatment method ( OR=29.168, 95% CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery ( OR=0.624, 95% CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion:Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation.

目的 观察痹祺胶囊联合阿仑膦酸钠在老年股骨颈骨折人工关节置换术后的治疗作用.方法 97例均为华北理工大学附属医院骨科于2017年1月—2019年1月收治的老年股骨颈骨折患者,入院后拟行人工双极股骨头置换术治疗,按随机数字表法分为3组.Ⅰ组34例,术后应用痹祺胶囊加碳酸钙/维生素D3片口服;Ⅱ组32例,术后给予阿仑膦酸钠加碳酸钙/维生素D3片口服;Ⅲ组31例,术后给予痹祺胶囊联合阿仑膦酸钠加碳酸钙/维生素D3片口服.3组的疗程均为4个月,术后随访4个月,观察3组术后第7天患肢大腿周径减少值(cm),术后引流管出血量(mL),疼痛视觉模拟评分(VAS),手术后3、7天超敏C-反应蛋白(hs-CRP)数值,术后1、4个月髋关节Harris评分,股骨假体Gruen分区1区骨密度值(BMD)和术后患者在助行器保护下间断下地行走所用时间.结果Ⅲ组患肢周径减少值大于Ⅰ、Ⅱ组(F=142.436,P＜0.01);3组术后出血量差异无统计学意义(F=0.063,P＞0.05);术后第7天Ⅲ组VAS评分低于Ⅰ、Ⅱ组(F=9.081,P＜0.01);hs-CRP值亦低于Ⅰ、Ⅱ组(F=7.304,P＜0.01).术后1个月和4个月Ⅲ组髋关节功能Harris评分较Ⅰ、Ⅱ组高(F分别为9.032,9.524,P＜0.01).术后4个月Ⅲ组股骨假体Gruen分区1区周围应力遮挡造成的BMD值减少在3组中最低(F=8.509,P＜0.01).术后Ⅲ组患者在助行器保护下间断下地行走所用的时间较Ⅰ、Ⅱ组短(F=12.028,P＜0.01).结论 老年股骨颈骨折人工关节置换术后应用痹祺胶囊联合阿仑膦酸钠口服有较好的消肿、消炎、止痛作用,可促进关节功能恢复,且可减少假体置换术后因应力遮挡所导致的骨质疏松.

目的 探讨鲑鱼降钙素和阿仑膦酸钠在股骨颈骨折内固定术后预防和治疗骨质疏松及股骨颈短缩中的作用.方法 2014年1月-2019年6月华北理工大学附属医院收治的采用股骨颈骨折空心钉内固定术治疗的118例老年患者,按简单随机分组法分为二组.第1组56例,给予鲑鱼降钙素治疗,第2组62例,给予阿仑膦酸钠治疗.比较二组患者术后9个月内骨密度值、骨折愈合时间、术后第9个月时股骨颈短缩程度及股骨头坏死率.结果 术后9个月二组骨密度值变化重复测量的方差分析所得分组、时间点、分组×时间点比较结果分别为(F=7.060,P=0.009)、(F=7.560,P=0.000)、(F=0.982,P=0.406);两种治疗方法提升骨密度效果存在差异,阿仑膦酸钠在术后提升骨密度效果较鲑鱼降钙素好,术后骨密度值随时间存在趋势性变化,这种变化与治疗方法不存在交互作用.术后9个月时,二组股骨颈短缩程度结果分别为(7.79±1.78)mm和(8.50±1.68)mm,鲑鱼降钙素组术后股骨颈短缩程度少于阿仑膦酸钠组,差异有统计学意义(P＜0.05).鲑鱼降钙素组与阿仑膦酸钠组术后骨折愈合时间分别为(4.82±1.15)个月和(5.35±1.24)个月,鲑鱼降钙素组愈合时间短于阿仑膦酸钠组,差异有统计学意义(P＜0.05).术后9个月二组髋关节Har-ris评分比较结果为(89.39±5.20)和(86.39±6.99),鲑鱼降钙素组术后髋关节功能较好,差异有统计学意义(P＜0.05).术后9个月时行MRI检查二组股骨头坏死率,鲑鱼降钙素和阿仑膦酸钠术后差异无统计学意义(P＞0.05).结论 股骨颈骨折内固定术后应用鲑鱼降钙素治疗可促进骨折愈合,减少股骨颈短缩,髋关节功能较好;而应用阿仑膦酸钠术后提升骨密度效果较好;术后9个月时,二组股骨头坏死率差异无统计学意义.

目的 探讨在新型冠状病毒肺炎防控期间通过制定梅尼埃病的调查问卷实现精准远程预约诊疗服务,减少院内人员流动、防止交叉感染和提高诊疗效率.方法 在2020年1月-2020年6月间通过电话或手机软件预约耳鼻喉门诊诊疗的梅尼埃病患者,随机分二组,问卷组65人,通过问卷形式预约来耳鼻喉门诊;普通问诊组71人,以普通问诊形式预约来耳鼻喉门诊,收集二组来院诊疗患者的确诊率并进行比较.将问卷所得分数通过受试者工作特征曲线(receiver operating characteristic curve,ROC),计算曲线下面积(area under curve,AUC),约登指数(youden index,YI).结果 问卷组患者确诊率为29.2％,普通问诊组来院确诊率为14.1％,二组比较发现差异有统计学意义(P＜0.05),问卷组确诊率显著高于普通问诊组(P=0.031).计算问卷组就诊患者所得分值后发现ROC曲线下面积AUC=0.733,95％的可信区间为(95％CI=0.608～0.857),最大约登指数YI=0.43,对应的诊断界值2.5.结论 通过梅尼埃病问卷表预约诊疗服务可提高确诊率,且具有中等强度的诊断价值,方便患者就医同时有助于减少医院人员流动,控制疫情.

目的 探讨对老年白内障患者实施临床护理路径干预的临床效果.方法 选取2016年6月～2017年7月我院收治的老年白内障患者900例,随机分为观察组(临床护理路径干预)和对照组(常规护理)各450例.对比两组住院时间、知识掌握程度评分、并发症发生率和患者满意度.结果 观察组住院天数[(4.19±0.65)d]和并发症发生率6.67％(30/450)均显著少于对照组住院天数[(9.42±1.78)d]和并发症发生率20.00％(90/450),差异有统计学意义(P<0.05),知识掌握程度评分[(92.73±6.55)分]显著高于对照组[(75.14±7.32)分],差异有统计学意义(P<0.05).观察组总满意度97.11％(437/450),与对照组总满意度84.00％(378/450)比较,显著升高(P<0.05).结论 对老年白内障患者实施临床护理路径干预效果显著,值得临床推广.

目的:观察痹祺胶囊联合充气颈托固定治疗颈椎早期病变的临床疗效.方法:选择华北理工大学附属医院就诊的60例颈椎病早期、低年龄段患者按就诊顺序随机分为治疗组和对照组,治疗组以痹祺胶囊(4粒,3次/d)口服,并用充气颈托固定(30min,3次/d),并联合颈部红外线治疗仪理疗15min,2次/d治疗.对照组以洛芬待因缓释片(1片,1次/d)口服并联合充气颈托和颈部红外线治疗仪理疗15min,2次/d治疗,两组疗程均为28d.采用McGill简化量表积分值评价治疗前及治疗后第7、14、21、28天颈部酸痛改善情况.观察治疗期间颈项肌肉僵硬改善时间,颈椎生理曲度变直恢复时间并进行比较.结果:与对照组比较,治疗组治疗过程中McGill简化量表积分变化、颈部肌肉僵硬缓解及生理曲度变直恢复时间均显著减少(P＜0.05),治疗组明显优于对照组.结论:痹祺胶囊联合充气颈托固定是一种简单、快速、有效的治疗颈椎早期病变的临床治疗方法.

目的 观察骨康胶囊用于促进鼻骨骨折恢复的临床疗效及安全性.方法 将80例外伤性闭合性鼻骨骨折患者随机分为对照组40例和试验组40例.对照组予以双氯芬酸钠每次75 mg,qd,口服;试验组予以骨康胶囊每次1.2 g,tid,口服.2组患者均治疗8周.比较2组患者鼻周软组织和鼻骨骨折的愈合情况,以及药物不良反应的发生情况.结果 治疗后,试验组和对照组的皮肤光亮消退时间分别为(3.50±0.88)和(5.50±1.41)d,淤血消退时间分别为(9.63±3.43)和(18.25±8.10)d,皮纹出现时间分别为(13.48±6.98)和(18.20±8.50)d,骨痂初现时间分别为(17.15±3.53)和(28.25±9.18)d,骨折线模糊时间分别为(29.80±9.40)和(35.75±12.54)d,骨折线消失时间分别为(42.80±12.51)和(55.50±6.97)d,差异均有统计学意义(均P<0.05).试验组治疗期间未见药物不良反应,对照组的药物不良反应以胃部不适为主.试验组和对照组的总药物不良反应发生率分别为0和12.50％,差异有统计学意义(P<0.05).结论 骨康胶囊在促进鼻周软组织和鼻骨骨折愈合方面的临床疗效确切,且短期用药安全.

Objective To compare the clinical treatment index and operation effect of external fixation and open reduction&internal fixation.Methods Forty-one patients with AO type C distal radius fracture were analyzed retrospectively from June 2013 to June 2016 in author's hospital.Among them,19 patients were treated with external fixation,and 21 patients were treated with open reduction&internal fixation.Results Patients treated with external fixation performed better than those treated with open reduction&internal fixation in operation time,bleeding amount,total hospital stay and fracture healing time,but less better in displacement of articular surface,shortening of radius,obliquity and ulnar deviation angle.The two groups performed no significant difference in Cooney scores and complication rates.Conclusion Different operations can be chosen according to patients'functional expectation.

目的 探讨体感诱发电位(somatosensory evoked potential,SSEP)在颈椎外伤前路手术中的作用.方法 2008-07-2015-02收治颈椎外伤前路手术患者53例,年龄16～69岁,男44例,女9例.对照组(33例)无SSEP监护,监护组20例.在麻醉诱导后摆放体位前确立SSEP基线,波幅降低50％或潜伏期延长＞10％为报警标准.记录SSEP报警因素、改善措施及有无医源性神经损伤.计算SSEP监护神经损伤的敏感性和特异性.结果 53例病人术后未出现新的神经损伤.SSEP监护颈椎外伤前路手术中神经损伤的敏感性和特异性为100％.结论 在颈椎外伤前路手术中SSEP监护医源性神经损伤是有意义的.