脊髓髓内肿瘤手术后应用甲基强的松龙冲击治疗的临床研究  

Clinical research of methylprednisolone pulse therapy in intramedullary spinal cord tumor surgery

作　　者：柴宏伟[1] 朱涛[1] 张士忠[1] 边涛[1] 

机构地区：[1]天津医科大学总医院神经外科,天津300052

出　　处：《天津医科大学学报》2009年第2期229-231,共3页Journal of Tianjin Medical University

摘　　要：目的:探讨脊髓髓内肿瘤术后应用甲基强的松龙(MP)对患者术后神经功能恢复的影响。方法:对73例脊髓髓内肿瘤患者行显微神经外科手术治疗。根据术后使用糖皮质激素药物情况分为两组:大剂量甲基强的松龙冲击治疗组(Ⅰ组)38例,甲基强的松龙常规剂量治疗组(Ⅱ组)35例。观察患者术后脊髓功能恢复情况,按JOA脊髓功能评分标准评定神经功能恢复率,并统计各组糖皮质激素相关并发症例数。结果:Ⅰ组术后6 h、术后第1天和术后第3天的神经功能恢复情况较好,但与Ⅱ组比较统计学无显著性差异;术后第7天、14天、术后3个月Ⅰ组脊髓功能恢复明显好于Ⅱ组,统计学处理其差异有统计学意义。Ⅰ组术后并发症出现较少,但多无统计学意义。结论:对脊髓髓内肿瘤患者术后应用大剂量MP冲击治疗能提高患者术后远期神经功能恢复率,且不增加糖皮质激素相关并发症的发生率。Objective： To investigate the effects of high-dosage stosstherapy of methylprednisolone（MP） on the recovery of postoperative neurological functions due to intramedullary spinal cord tumors. Methods： 73 cases of intramedullary spinal cord tumor patients with the treatment of micro-neurosurgery were divided into two groups according to the postoperative use of glucocorticoid drugs： high-dose methylprednisolone pulse therapy group （ Ⅰ ）, 38 cases; conventional dose of methylprednisolone group （Ⅱ ）,35 cases. Postoperative neurological function recovery rate were evaluated by the JOA scores.The glucocorticoid related complications of both groups were recorded. Results： Statistical analysis showed that there were no significant diference in the neurological function recovery rate between the two groups on the 6 hours, first and third day postoperatively. While compared with the control group,significant improvement of neurological function were found in the group Ⅰ on the 7th day,14th day and 3 months after operation. Group Ⅰ appeared less complications than the control group, but no statistical significant diference. Conclusion： High-dosage stoss-therapy of methylprednisolone after surgery in patients with intramedullary spinal cord tumors can improve postoperative neurological function recovery rate significantly and does not increase glucocorticoid-related complications.

关 键 词：甲基强的松龙 脊髓髓内肿瘤 神经功能 

分 类 号：R739.42[医药卫生—肿瘤]