腰椎间盘摘除术局部与全身使用糖皮质激素临床疗效的比较  

Comparison of clinical outcomes between local and systemic application of steroids combined with microendoscopic discectomy

作　　者：曾钢[1] 李春海[1] 任晋可[1] 叶伟[1] 陈晋宸[1] 朱海鹏[1] 

机构地区：[1]中山大学附属孙逸仙纪念医院骨科,广东省广州市510120

出　　处：《中国骨与关节损伤杂志》2014年第3期221-223,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较椎间盘镜(MED)下椎间盘切除术治疗腰椎间盘突出症时,术中配合神经根局部使用糖皮质激素与术后全身使用糖皮质激素临床疗效的差别。方法本研究为前瞻性的随机对照研究,包括自2011-02—2013-05接受MED治疗的40例患者。通过评价术中神经根局部使用糖皮质激素组与术后全身使用糖皮质激素组术前和术后第3天及第7天的腰痛及下肢疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)评分及改善率以及不良反应,评估2种治疗方法的临床疗效。结果每组各20例入组。2组术前临床资料比较,差异均无统计学意义。局部使用激素组的术后评价指标包括术后第3天及第7天腰痛及下肢疼痛VAS评分、JOA评分均明显低于全身使用激素组,JOA改善率明显高于全身使用激素组,2组均未发生明显不良反应。结论术中神经根局部使用糖皮质激素较全身使用糖皮质激素更能有效减轻术后短期疼痛,恢复功能。Objective To compare the clinical results between local and systemic application of steroid combined with microendoscopic diskectomy （MED） in the treatment of lumbar disc herniation. Methods A prospective randomized controlled trail of 40 patients who had undergone MED from February 2011 to May 2013 was performed. Clinical results were assessed by comparing the following parameters between patients who had undergone MED combined with local and systemic application of steroid： visual analogue scale （VAS） score of back pain and leg pain, Japanese Orthopedic Associatlon（JOA） score and recovery rate,the adverse reaction at pre-operation, and 3,7 days after operation. Results Twenty patients underwent MED combined with local application of steroid, and the other 20 patients underwent MED combined with systemic application of steroid. No significant difference was found in pre-operative data between the two groups. The VAS score, post- operative JOA score at 3, 7 days after the operation in local application of steroid group were significantly lower than that of systemic application of steroid group, and JOA recovery rate was the opposite. No obvious adverse reaction occurred in the two groups. Conclusion Local application of steroid is more efficient in post-operative pain relief as well as functional improvement in a short time compared with systemic application of steroid.

关 键 词：腰椎间盘突出 椎间盘切除术 糖皮质激素 神经根 

分 类 号：R687.3[医药卫生—骨科学]