脊髓损伤后急腹症临床特点的细化及机制分析

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Abstract Objective To summarize the clinical manifestations and signs of acute abdominal emergency(AAE) in patients with spinal cord injury(SCI).Methods The medical records of SCI patients over 14 years old admitted to China rehabilitation research center from January 2010 to February 2019 were retrospectively analyzed.Results All the 〓4 396 patients with SCI were included，and a total of 38 patients were newly diagnosed with AAE.There were 16 cases of acute cholecystitis，15 cases of intestinal obstruction，3 cases of pancreatitis，2 cases of appendicitis and 2 cases of perforation and rupture of viscera.The AIS classification of SCI was grade A in 25 cases，grade B in 3 cases，grade C in 8 cases，and grade D in 2 cases.The first symptom was abdominal distension in 24 cases，abdominal pain in 17 cases，abdominal muscle tension in only 3 cases.The incidence of cholecystitis and ileus was 0.36％ and 0.34％ respectively.4 case of severe AAE：1 gastric perforation，1 intestinal rupture and 2 acute gangrene cholecystitis.None had typical signs of AAE.Conclusion The diagnosis of AAE based on the classic manifestations and signs is not suitable for patients with high level SCI.Acute cholecystitis is the most common cause of AAE in patients with SCI.Abdominal distension is the most common complaint in patients in AAE with SCI.The possibility of abdominal organ damage should be considered when patients with SCI experience hypotension that cannot be corrected due to change of body position，abnormal increase of muscular tone and abnormal increase of urine leakage.Imaging examination and laboratory examination are effective means to improve the diagnosis rate of AAE in patients with SCI.

Key words： spinal cord injury acute abdominal emergency visceral pain

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I9/773

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