骨科医师分会骨科循证临床诊疗指南：成人急性下颈段脊柱脊髓损伤循证临床诊疗指南

指南与规范·中国医师协会骨科医师分会骨科循证临床诊疗指南：成人急性下颈段脊柱脊髓损伤循证临床诊疗指南中国医师协会骨科医师分会中国医师协会骨科医师分会《成人急性下颈段脊柱脊髓损伤循证临床诊疗指南》编辑委员会【摘要】为了给中国的骨科医师提供关于急性下颈段脊柱脊髓损伤的临床诊疗指南，中国医师协会骨科医师分会脊柱创伤工作组组织相关专家撰写了本指南。本指南适用于3周内的成人外伤性下颈段（颈3"颈）椎体的骨折和（或）脱位，伴或不伴有脊髓、神经根损伤。工作组通过设置问题、确定检索词来检索中英文文献，按照纳入和排除标准筛选文献；然后详细分析最终纳入的证据文献，确定证据等级，给出相应的推荐建议。本指南最终纳入了141篇文献，其中中文27篇，英文114篇。设置了18个问题.分为院前急数、诊断与评估、治疗和并发症防治四大部分，共有39个推荐条目。【关键词】下颈椎：脊柱脊髓损伤：诊断：评估：治疗：临床诊疗指南Evidence-based guidel ine for the management of acute subaxial cervical spine injury ChineseAssociation of Or thopedic Surgeons,The Editorial Committee of the Eviderce-based puideline for themanagement of acute subaxial cervical spine injury'of Chinese Association of Or thopedic SurgeonsCorresponding author:Sun Tiansheng.Department of Or thopedics Army General Hospital Beijing 100700.China Ema il suntiansheng-@163.com[Abstract In order to provide the clinical guidelines of acute subaxial cervical spine injury for theChinese or thopedic surgeons.the Spine Trauma Group of Chinese Association of Orthopedic Surgeonscompi led this guidelines.The guidel ines apply to adult patients with acute less than 3 weeks)subaxialcervical spine and/(or)spinal cord or nerve root injuries.The Study Group wrote the guidelines by settingup questions.determining search words.screening literatures according to inclusion and exclusion criteria.analyzing the includled literatures,confirming evidence levels and then providing recommerdations.Theguidelines include 141 literatures,27 Chinese articles and 114 English articles.The guidelines set u18gdiprospita care.diagnosis and evaluation,treatment ad prevention ofcompl itations which include 39 reto mmendation s[Key words]Subaxial cervical spine:Spinal cord injury:Diagnosis:Evaluation:Treatment:Cl inical guidel ines一、背景师分会脊柱创伤工作组组织相关专家撰写了本指流行病学研究结果显示，下颈段（颈3~颈7）损南。本专家组在《新鲜下颈段脊柱脊髓损伤评估与伤在急性脊柱脊髓损伤中约占15.2%.在颈椎损伤治疗》【四的基础上，参考了美国神经外科医师年会中约占63.5%【】。由于受伤机制复杂，常伴随颈脊(Congress of Neurological Surgeons.CNS)2013髓损伤。治疗棘手、致残率高。给脊柱外科医师带来的《急性颈椎脊柱脊髓损伤诊疗指南》，借鉴其制定巨大挑战。方法，检索并分析已发表的有关急性下颈段脊柱脊为了给中国的骨科医师提供关于急性下颈段脊髓损伤的中英文文献，制定了本指南。柱脊髓损伤的临床诊疗指南，中国医师协会骨科医二、方法学本指南工作组专家根据目前下颈段脊柱脊髓损001:10.3760/cma.j.issn.0529-5815.2018.01.003伤诊治中的难点和重点，明确临床上需要解决的问通信作者：孙天胜100700北京，陆军总医院骨科，ail:题，根据这些问题来确定需要制定的指南内容。通suntiansheng-6 163.com过确定检索词和检索年限。检索中英文文献，按照纳