甲基强的松龙在脊髓型颈椎病围手术期中的应用  

Perioperative application of methylprednisolone on cervical spondylotic myelopathy

作　　者：张黎龙[1] 田融[1] 夏刚[1] 申庆丰[1] 江汉[1] 田成瑞[1] 

机构地区：[1]天津市人民医院脊柱外科,天津300121

出　　处：《临床骨科杂志》2008年第3期207-209,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨甲基强的松龙(MP)在脊髓型颈椎病(CSM)对脊髓减压术后神经功能恢复的影响。方法脊髓型颈椎病患者67例,根据MP不同用法随机分为3组。A组21例:术中减压前30 min应用MP 1000mg,静脉输液,术后应用MP 80mg,静脉输液,qd×5d;B组24例:术中减压前30min应用MP 1000mg,静脉输液,术后应用地塞米松10mg,静脉输液,qd×5 d;C组22例:术后应用地塞米松10mg,静脉输液,qd×5d。术前、术后1周、术后6个月按JOA评分进行比较。结果术前3组JOA评分比较差异无显著性(P>0.05)。术后1周、术后6个月3组JOA评分改善率比较差异皆有显著性(P<0.05)。结论脊髓型颈椎病患者术中减压前30min和术后应用MP可促进神经功能的恢复。Objective To research the effects of different perioperative application of methylprednisolone （MP） on the recovery of postoperative neurological functions of cervical spondylotic nayelopathy （CSM）. Methods According to different dosage and use of MP, 67 cases of CSM, which underwent cervical spine surgery, were divided into 3 groups ： A, B and C. Group A （ 1 000 mg, intraoperative ＋ 80 mg, postoperative）, qd × 5 d,21 cases ; Group B （ 1 000 mg,intraoperative ＋ 10 mg dexamethasone sodium, postoperative） , qd × 5 d,24 cases ; Group C （ 10 mg dexanaethasone sodium, postoperative）, qd × 5 d,22 cases. The preoperative, short-term （ 1 week） and long-term （ half year） neurological function recovery rates by JOA scores were observed. Results There was no statistical significant difference between group A, B and C for the preoperative JOA scores （ P 〉 0.05 ）. The recovery rates of JOA scores were significant difference between group A, B and C （P 〈0.05）. Conclusions MP used intraoperatively and low dose MP used postoperatively on CSM can improve postoperative neurological functions recovery.

关 键 词：甲泼尼龙 脊髓型颈椎病 围手术期 神经功能 

分 类 号：R681.5[医药卫生—骨科学] R977.11[医药卫生—外科学]