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腰椎疾病致马尾神经损伤实现早期诊治

2012-04-20 唐宾泽 医学论坛网

  上海第二军医大学附属长征医院一项题为《腰骶椎疾病致马尾神经损害的基础与临床》的研究,揭示了马尾神经损伤的发病机制,据此形成“早期诊断、早期治疗、最佳手术时机选择、急性综合救治、术后抗氧化治疗”等一系列临床诊治优化模式,大大降低了马尾神经损伤的发病率,马尾神经损伤治疗总有效率达到93%。这项科研成果获全国高等院校优秀研究成果科学技术进步二等奖。   上世纪90年代开

  上海第二军医大学附属长征医院一项题为《腰骶椎疾病致马尾神经损害的基础与临床》的研究,揭示了马尾神经损伤的发病机制,据此形成“早期诊断、早期治疗、最佳手术时机选择、急性综合救治、术后抗氧化治疗”等一系列临床诊治优化模式,大大降低了马尾神经损伤的发病率,马尾神经损伤治疗总有效率达到93%。这项科研成果获全国高等院校优秀研究成果科学技术进步二等奖。

  上世纪90年代开始,在上海第二军医大学附属长征医院袁文教授和贾连顺教授的指导下,史建刚领衔的研究团队,在马尾神经损害的基础与临床研究领域开展了一系列研究,在国内外首次揭示了马尾神经损伤的“双向馈变”的发病机制。当马尾神经遭受急性压迫时,则形成恶性循环,不仅压迫的马尾神经自身发生变性,还可顺行性产生背根神经节变性、逆行性产生脊髓神经元变性,而导致所支配区域感觉障碍,造成膀胱、肛门括约肌的功能障碍和性功能障碍等。

  课题组从发病机制入手,打破了沿袭多年的以“发病时间”为发病起点的诊断观点,创新性地提出了以“症状体征”为依据的分期方法,明确了患者可以在神经坏死之前就确定发病的起点。掌握了以“症状体征”为依据的分期方法,就可准确测量“临床前期和临床早期”疾病的发病情况,实现了早期诊断和治疗,大大减少了马尾神经损伤发病率。

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