围手术期应用甲基强的松龙对巨大型腰椎间盘突出症术后神经功能的影响  

The effect of administering of methylprednisolone peri-operatively on neural function recovery in patients with huge lumbar disc herniation

作　　者：陈博来[1] 林定坤[1] 孔畅[1] 陈海云[1] 

机构地区：[1]广东省中医院骨科,广东省广州市510120

出　　处：《中国脊柱脊髓杂志》2007年第5期365-367,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨巨大型腰椎间盘突出症患者围手术期应用甲基强的松龙(methylprednisolone,MP)对其神经功能恢复的影响。方法:巨大型腰椎间盘突出症患者60例,均采用半椎板切除、单纯髓核切除手术治疗,其中围手术期应用MP治疗组30例,术前30min及术后第l、2、3天静脉快速(30min内)给予MP160mg;对照组30例,未使用MP治疗。应用JOA评分及腰痛功能障碍评价表(Oswestry)评价两组患者术前和术后神经功能情况。结果:治疗组及对照组患者术前JOA评分分别为10±1.8分和10±2.4分,Oswestry术前评分分别为34±5.7分和34±2.2分,两组间无显著性差异(P>0.05)。术后4d时治疗组与对照组的JOA评分分别为19±1.4分和18±2.7分;3个月时JOA评分分别为23±1.5分和21±2.6分,Oswestry评分分别为17±3.3分和19±1.6分,治疗组均优于对照组,两组相比有显著性差异(P<0.05)。治疗组神经牵拉伤1例,对照组2例;两组均未出现消化道溃疡、切口感染等并发症。结论:巨大型腰椎间盘突出症患者围手术期使用MP可明显改善其神经功能。Objective：To evaluate the effects of prophylactic use of methylprednisolone（MP） on neural function recovery in patients with lumbar intervertebral disc herniation.Method：60 cases of lumbar intervertebral disc herniation were selected, among which, 30 cases were treated with MP before and after decompression procedure.160mg MP was administered within 30 min first, the second and the third day after operation, the before operation and the same dose was used in the other 30 cases did not administered MP as a control. Preoperative and postoperative neurological function was graded on JOA scale and ODI.Result：JOA and Oswestry score of MP group and control group before surgery was 10±1.8,34±5.7 and 10±2.4,34±2.2 respectively,no remarkable significance （P〉0.05）.However,JOA and Oswestry score of two groups after surgery had remarkable significance （P〈0.05）.One traction injury of nerve roots happened in MP group,and 2 in control group.Digestive ulcer,infection related to MP did not appear in two group.Conclusion：Administering methylprednisolone before and after decomoression orocedure can significantly imorove spinal cord function.

关 键 词：腰椎间盘突出症 治疗 甲基强的松龙 神经功能 

分 类 号：R681.5[医药卫生—骨科学] R977.1[医药卫生—外科学]