促红细胞生成素在重症脊髓型颈椎病围手术期的应用  

Erythropoietin administrated in the perioperative period of severe cervical spondylotic myelopathy

作　　者：熊敏[1] 李锋[2] 余化龙[1] 曾云[1] 刘志刚[1] 陈森[1] 

机构地区：[1]湖北医药学院附属东风医院脊柱外科,十堰442000 [2]华中科技大学同济医学院附属同济医院骨科

出　　处：《中华实验外科杂志》2012年第5期961-962,共2页Chinese Journal of Experimental Surgery

摘　　要：目的观察促红细胞生成素（EPO）治疗重症脊髓型颈椎病脊髓功能恢复情况，探讨EPO在重症脊髓型颈椎病围手术期治疗中的应用价值。方法2009年6月至2010年6月间我科行手术治疗的重症脊髓型颈椎病病例43例，随机分为2组。其中22例（A组）围手术期使用EPO，21例（B组）不使用EPO。记录术前、术后1周、术后1年日本骨科学会（JOA）评分计算患者的神经功能恢复率，统计并发症。使用ODOM标准评估远期神经功能变化。结果两组年龄、性别构成差异无统计学意义，组间术前JOA评分差异无统计学意义（P〉0．05）。所有患者均获1年以上随访，无死亡，无失访，未出现高血压、血栓疾病、心脑血管意外等并发症。影像学提示颈椎植骨融合良好，内固定稳定。与术前比较，术后1周及1年JOA评分均显著增加，差异有统计学意义；组间比较，A组改善率明显高于B组（P〈0．05）。1年后ODOM评分，A组改善率明显高于B组（P〈0．05）。结论EPO的在围手术期的使用安全有效，能明显提高重症脊髓型颈椎病患者术后神经功能的恢复率。Objective To study the applied value of erythropoietin （EPO） in patients with severe cervical spondylotie myelopathy during perioperative period. Methods From June 2009 to June 2010, 43 patients with severe cervical spondylotic myclopathy were subjected to decompression surgery, including 22 cases （group A） given EPO （3000 IU, three times per week for 8 weeks, and 21 cases （group B） without application of EPO perioperatively. The neurological function in perioperative period was compared in terms of JOA and ODOM score systems between two groups. Results All the patients were followed up for at least 12 months after the surgery, and there were no deaths in the perioperative period. No complications occurred at the end of the follow-up duration. All patients in both two groups had great improvement in JOA and ODOM score in different periods when compared to the preoperative score. Group A had a much higher score in JOA and ODOM than group B one year after the surgery （ P 〈 0. 05 ）. Conclusion The application of EPO during the perioprative period would greatly improve the recovery rate of neurological function in patients with severe cervical spondylotic myelopathy, and the usage was safe and effective.

关 键 词：促红细胞生成素 脊髓型颈椎病 

分 类 号：R687.3[医药卫生—骨科学]