中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (33): 3077-3086.doi: 10.3969/j.issn.1673-5374.2013.33.001

• 原著:脊髓损伤修复保护与再生 •    下一篇

中国胸腰段脊柱脊髓新鲜损伤评估与治疗的专家共识

  

  • 收稿日期:2013-04-22 修回日期:2013-06-01 出版日期:2013-11-25 发布日期:2013-11-25
  • 基金资助:

    首都医学发展基金（2005-2016）《多中心前瞻性急性脊柱脊髓损伤标准化治疗的临床及实验研究》和军队十一五科技攻关课题《多中心前瞻性急性脊柱脊髓损伤标准化治疗的临床及实验研究》的支持（06G028）

An expert consensus on the evaluation and treatment of acute thoracolumbar spine and spinal cord injury in China

Zhicheng Zhang, Fang Li, Tiansheng Sun   

  1. PLA Institute of Orthopedics, Beijing Army General Hospital of Chinese PLA, Beijing 100700, China
  • Received:2013-04-22 Revised:2013-06-01 Online:2013-11-25 Published:2013-11-25
  • Contact: Tiansheng Sun, M.D., Professor, PLA Institute of Orthopedics, Beijing Army General Hospital of Chinese PLA, Beijing 100700, China, suntiansheng-@163.com.
  • About author:Zhicheng Zhang, M.D., Attending physician.

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摘要：

文章为中国从事脊柱脊髓研究治疗的相关专家的公识，历经从2009年到2010年7月的时间历程。专家共识主要分概述（1条）、院前急救（1条）、诊断与评估（13条）、治疗（23条）、主要并发症防治（12条）、康复治疗（4条）等共6部分，推荐条目共54条。共有30位专家（主任医师、高年资副主任医师）及40位普通参会代表进行投票。专家组投票：低级推荐程度的建议0条，9条为中级推荐程度，45条为高级推荐程度；普通代表组，低级推荐程度2条，中级推荐程度12条；高级推荐程度为40条；所有投票混合后，再次计算后低级推荐程度0条，中级推荐程度10条，高级推荐程度44条。虽然在在不同推荐条目上专家组和普通代表组有一定的不同，但不同组别中推荐程度为低级和中级的推荐条目较为集中，专家共识大多数推荐条目为中高级推荐程度，将针对中低级推荐较为集中的条目进行进一步论证和修复，并进行下一轮的专家组讨论修改，并希望将其推广到中国同道共同认可的急性胸腰段脊柱脊髓损伤处理规范，以规范急性胸腰段脊柱脊髓损伤评估和治疗。

关键词: 神经再生, 脊髓损伤, 专家共识, 胸腰段脊柱脊髓损伤, 指南, 循证医学, 神经功能, 诊断, 治疗, 康复, 基金资助文章

Abstract:

This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab-lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommendations including the overview (one item); pre-hospital care (one item); evalu-ation and diagnosis (13 items); treatment (23 items); prevention and treatment of major complica-tions (12 items); and rehabilitation (four items). This is the first time that Chinese experts have pub-lished a consensus on spine and spinal cord injury. The expert consensus was established based on Delphi methods, literature analysis, and clinical experiences. Each recommendation is supported by and was interpreted using multi-level evidences. The level of agreement with the recommenda-tion among the panel members was assessed as either low, moderate, or strong. Each panel member was asked to indicate his or her level of agreement on a 5-point scale, with “1” corre-sponding to neutrality and “5” representing maximum agreement. Scores were aggregated across the panel members and an arithmetic mean was calculated. This mean score was then translated into low, moderate, or strong. After all of the votes were collected and calculated, the results showed no low-level recommendations, 10 moderate-level recommendations, and 44 strong-level recom-mendations. An expert consensus was reached and was recognized by Chinese spine surgeons. Wide-scale adoption of these recommendations is urgent in the management of acute thoracol-umbar spine and spinal cord injury in a broader attempt to create a standard evaluation and treat-ment strategy for acute thoracolumbar spine and spinal cord injury in China.

Key words: neural regeneration, spinal cord injury, expert consensus, thoracolumbar spine and spinal cord injury, guidelines, evidence-based medicine, neurological function, diagnosis, treatment, rehabilitation, grant-supported paper, neuroregeneration