摘要
目的:探讨围手术期预防性应用甲基强的松龙(MP)对发育性颈椎管狭窄(DCS)合并脊髓型颈椎病(CSM)患者脊髓减压术后神经功能恢复的影响。方法:62例DCS合并CSM患者,根据围手术期是否应用MP分为2组,MP组:32例,术中脊髓减压前30min以MP 30mg/kg静滴(15min内滴完),45min后继以5.4mg/kg/h维持用药23h;对照组:30例,术中脊髓减压前给予地塞米松15mg静脉点滴,术后地塞米松10mg静滴×3d。术后3d、7d、1个月、6个月和12个月按JOA评分标准评定两组患者的神经功能改善率[(术后JOA评分-术前JOA评分)/(17-术前JOA评分)×100%],观察统计并发症。结果:术后3d两组患者神经功能改善率比较无显著性差异(P>0.05),术后7d时MP组与对照组神经功能改善率分别为(68.43±9.89)%、(49.67±11.45)%,有显著性差异(P<0.05),术后1个月时分别为(77.32±11.24)%、(61.65±10.42)%(P<0.05),术后6个月时分别为(81.12±10.42)%、(70.45±9.22)%(P<0.05),术后12个月时分别为(83.15±8.57)%、(81.77±11.61)%(P>0.05)。术后对照组有4例出现肩痛,MP组无严重并发症出现。结论:DCS合并CSM患者围手术期预防性应用MP能提高手术的安全性及术后近期神经功能改善率,未增加严重不良反应的发生。
Objective：To investigate the effect of prophylactic administration of methylprednisolone（MP） on the recovery of neurological functions after the decompression of spinal cord in developmental cervical stenosis （DCS） accompanied with cervical spondylotic myelopathy （CSM） in perioperation.Method：62 cases of DCS accompanied with CSM were divided into 2 groups according to application of MP or not in perioperation.32 patients in MP group were treated with MP stoss （30mg/kg,iv,15min） 30min prior to the decompression and then,after 45min intermission,sequenced with MP（5.4mg/kg/h,iv） in the following 23h postoperation.30 cases in the control group were treated with dexamethasone 15mg 30min prior to the decompression and then sequenced with dexamethasone （10mg,iv,qd×3d） in postoperation.Neurological function improvement rates were evaluated according to the JOA scores [（postoperative JOA scores-preoperative JOA scores）/（17-preoperative JOA scores）×100%] at 3d,7d,1 month,6 months and 12 months postoperation,and complications were observed and recorded in both groups.Result：There was no significant difference of the neurological function recovery rate between the two groups at 3d postoperation （P〉0.05）.Neurological function recovery rates were （68.43±9.89）% in MP group and （49.67±11.45）% in the control group at 7d postoperation（P〈0.05）.Neurological function recovery rates were （77.32±11.24）% in MP group and （61.65±10.42）% in the control group at 1 month postoperation （P〈0.05）,（81.12±10.42）% and （70.45±9,22）% respectively at 6 months postoperation （P〈0.05）,（83.15±8.57）% and （81.77±11.61）% respectively at 12 months postoperation（P〉0.05）.Shoulder pain occurred postoperatively in 4 cases in the control group while no serious side-effect occurred in MP group. Conclusion：Prophylactic administration of MP in perioperation for the patients with DCS accompanied with CSM can improve operative security and neurological funct
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第10期765-768,共4页
Chinese Journal of Spine and Spinal Cord
关键词
甲基强的松龙
发育性颈椎管狭窄
脊髓型颈椎病
神经功能
Methylprednisolone
Developmental cervical stenosis
Cervical spondylotic myelopathy
Neurological function
