围手术期使用神经妥乐平预防颈椎后路手术后轴性痛的前瞻性研究  

A prospective study on axial pain after cervical posterior approach surgery and the perioperative administration of neurotropin

作　　者：龙厚清[1] 陈文立[2] 徐晶辉 谢文翰[1] 黄阳亮[1] 刘少喻[1] 李佛保[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广州510080 [2]中山大学附属第一医院神经外科,广州510080

出　　处：《中国矫形外科杂志》2015年第1期22-25,共4页Orthopedic Journal of China

摘　　要：[目的]观察围手术期使用神经妥乐平对颈椎后路术后轴性痛的预防作用和近期疗效。[方法]2012年3月~2013年3月间,将颈椎后路手术患者随机分为治疗组（神经妥乐平组,n=62）和对照组（Vit-B12组,n=58）。术前1 d用药,连续应用至术后7 d。比较两组轴性痛发生率、疼痛模拟视觉评分（VAS）、日本骨科学会（JOA）、生活质量评分（QOL）差异。MRI测量比较两组颈后伸肌群肌萎缩程度（MAD）。[结果]术后早期轴性痛发生率两组无显著性差异（P〉0.05）,4、12周治疗组轴性痛发生率显著低于对照组（P〈0.05）,术后3 d两组平均疼痛水平无统计学差异,术后4、12周治疗组平均疼痛水平明显低于对照组（P〈0.05）。两组术后JOA评分及恢复率差异无统计学意义（P〉0.05）。治疗组术后12周QOL显著优于对照组（P〈0.05）,治疗组颈后伸肌群MAD明显小于对照组（P〈0.05）。[结论]围手术期使用神经妥乐平可减轻颈椎后路手术后颈后深肌群萎缩,预防轴性痛发生。[Objective] To prospectively observe the preventive effect and preliminary outcomes of alleviating axial pain after cervical posterior approach surgery by administering neurotropin（ NT） perioperatively. [Methods] From March 2012 to March 2013,120 patients who underwent cervical posterior approach surgery were categorized into the therapeutic（ NT group,n= 62） and vitamin B12（ control group,n = 58） groups. One day before surgery,7. 2 IU / d of NT was administered and was prescribed for 7 days postoperatively in the NT group. The axial pain incidence rates were compared between the groups. The degree of pain, recovery rate of neural function, and quality of life（ QOL） were evaluated using the visual analogue scale（ VAS）,Japanese Orthopedic Association（ JOA）,and QOL scores at day 3,week 4,and week 12,respectively. The muscle atrophy degree of cervical posterior deep muscles by magnetic resonance imaging were measured and compared between the groups at 12 weeks postoperatively. [Results] There were no significant differences with regard to the axial pain incidence rate between the groups at 3 days postoperatively（ P 〉 0. 05）,but the rate was significantly lower in the NT group at 4 and 12 weeks postoperatively（ both,P 〈 0. 05）. There were no significant differences in the degree of pain between the groups at 3 days postoperatively; however,it was significantly decreased in the NT group at 4 and 12 weeks postoperatively（ both,P 〈 0. 05）.There were no significant differences in the JOA score between the groups（ P 〉 0. 05）. The QOL score was significantly higher in the NT group than in the control group（ P 〈 0. 05）. The muscle atrophy degree in the control group was significantly more severe than that of the NT group（ P 〈 0. 05）. [Conclusion] Cervical posterior deep muscle atrophy can be alleviated using NT,and the postoperative cervical axial pain incidence rate can also be decreased.

关 键 词：轴性痛 神经妥乐平 颈椎后路手术 

分 类 号：R687[医药卫生—骨科学]