Abstract：
Each year approximately one million people suffer spinal cord injury, which has significant physical, psychosocial and economic impacts on patients and their families. Spinal cord rehabilitation centres are a well-established part of the care pathway for patients with spinal cord injury and facilitate improvements in functional independence and reductions in healthcare costs. Within the UK, however, there are a limited number of spinal cord injury centres, which delays admission. Patients and their families often perceive that they are not receiving specialist care while being treated in non-specialist units. This review aimed to provide clinicians who work in non-specialist spinal injury centres with a summary of contemporary studies relevant to the critical care management of patients with cervical spinal cord injury. We undertook a targeted literature review including guidelines, systematic reviews, meta-analyses, clinical trials and randomised controlled trials published in English between 1 June 2017 and 1 June 2023. Studies involving key clinical management strategies published before this time, but which have not been updated or repeated, were also included. We then summarised the key management themes: acute critical care management approaches (including ventilation strategies, blood pressure management and tracheostomy insertion); respiratory weaning techniques; management of pain and autonomic dysreflexia; and rehabilitation.
摘要：
每年大约有100万人遭受脊髓损伤，具有重要的物理意义，对患者及其家庭的社会心理和经济影响。脊髓康复中心是脊髓损伤患者护理途径的一个完善的部分，有助于改善功能独立性和降低医疗成本。在英国，然而,脊髓损伤中心数量有限，延误了入场。患者及其家人通常认为他们在非专科病房接受治疗时没有接受专科护理。这篇综述旨在为在非专业脊柱损伤中心工作的临床医生提供与颈脊髓损伤患者重症监护管理相关的当代研究总结。我们进行了有针对性的文献综述，包括指南，系统评价,荟萃分析，2017年6月1日至2023年6月1日以英文发表的临床试验和随机对照试验.在此之前发表的涉及关键临床管理策略的研究，但没有更新或重复，也包括在内。然后，我们总结了关键管理主题：急性重症监护管理方法(包括通气策略，血压管理和气管造口术插入）；呼吸断奶技术；疼痛和自主神经反射异常的管理；和康复。
