摘要
目的探索大量同种异体骨应用于多节段脊柱融合后小剂量短疗程应用肾上腺糖皮质激素的效果。方法对2004年5月～2007年1月间收治的106例行多节段脊柱融合的脊柱侧凸患者进行回顾性分析。依照术后是否应用激素分为两组，激素组：68例，其中男19例，女49例。融合节段7～12个节段（平均9．0个节段）。术后小剂量应用激素5～7d；非激素组：38例，其中男11例，女27例，融合节段6～12个节段（平均9．0个节段）；术后不应用激素。所有病例均为后路矫形植骨TSRH系统内固定。比较术后2组患者的体温、白细胞、血沉、引流量和术后并发症是否存在差异。结果激素组术后体温、外周血白细胞、血沉和切口深部引流量较非激素组迅速下降，2组间差异有统计学意义（P〈0．01）；术后切口红肿发生率差异也有统计学意义（P〈0．05），其它并发症的发生率差异无统计学意义（P〉0.05）。结论在脊柱侧凸多节段脊柱融合术后，小剂量短疗程应用激素可以使患者迅速地安全渡过同种异体骨移植所引起的免疫反应，减少并发症的发生。
Objective To study the effect of short course of mini dose hormonal application after long-segment spinal fusion using allograft bone in scoliosis. Methods A retrospective study was made in 106 patients with scoliosis, who underwent posterior spinal fusion during May, 2004 to Jan, 2007 in our hospital. These patients were divided into two groups. Hormone group, 68 cases, were 13 to 28 years old with a mean age of 16. 5 years old. The average fused segments were 9. 0 vertebrae （range from 7 to 12 vertebra）. Glucocorticoid was used after operation about 5 to 7 days. No hormone group, 38 cases, were 14 to 30 years old with a mean age of 17.5 years old. The average fused segments also were 9. 0 vertebrae （range from 6 to 12 vertebra）. No glucocorticoid was used after operation. All patients received spinal instrumentation with TSRH system and spinal fusion with allograft bone. The temperature, white blood cell （WBC）, ESR, drainage and complications between two groups after operation were comparative analyzed. Result Between two groups, the variance of the figures of the temperature, WBC ,ESR and drainage are statistically significant. There was less complication in hormone group than that in no hormone group. Conclusion After the operation of the segments spinal fusion by allograft bone, using mini-dose glucocorticoid by short course of treatment can significantly decrase some complications and ensure spinal fusion.
出处
《中国医师杂志》
CAS
2008年第6期764-766,共3页
Journal of Chinese Physician
基金
湖南省卫生厅科研基金资助（B2006-040）
湖南省科技厅科技计划一般项目资助（06SK3015）
