牛痘疫苗接种家兔炎症皮肤提取物早期治疗颈髓过伸伤的疗效观察  

Preliminary observation of effects of extrace from inflammatory cutaneous tissues of the rabbit inoculated with vaccina virus in the treatment of hyperextension injuries of cervical spinal cord

作　　者：接健[1] 陈福扬[2] 冯玉旭[2] 徐国浩[2] 王梅生[2] 

机构地区：[1]南京医科大学附属南京医院浦口分院,211800 [2]南京市浦口区中心医院骨科,211803

出　　处：《中国骨与关节杂志》2014年第12期953-956,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨早期应用牛痘疫苗接种家兔炎症皮肤提取物(Neurotropin,NTP)治疗颈髓过伸伤的初步临床疗效。方法2010年1月至2014年1月,我科收治的部分颈椎过伸伤患者20例,随机数表法分为NTP组(NTP治疗)和对照组(非NTP治疗)。NTP组应用NTP结合牵引治疗3周后,石膏固定3个月;对照组仅行颌枕带牵引治疗3周,石膏固定3个月。应用视觉模拟评分法(visual analogue scale,VAS)测定两组患者的疼痛、肢体麻木及触电感,并记录和比较两组治疗前、牵引结束时以及治疗结束时的评分。结果牵引结束时,NTP组患者疼痛、肢体麻木及触电感均较治疗前明显改善,其疼痛、肢体麻木及触电感的VAS评分(1.2±0.78)分、(1.6±0.84)分、(0.6±0.51)分均较治疗前(6.2±1.81)分、(5.3±1.15)分、(5.4±0.84)分明显减少,差异有统计学意义(P<0.05);对照组除触电感外患者疼痛、肢体麻木感的VAS评分(2.3±0.82)分、(2.9±0.99)分也均较治疗前(7.1±1.37)分、(4.3±1.56)分明显减少,差异有统计学意义(P<0.05);且NTP组患者疼痛、肢体麻木及触电感VAS评分分别小于对照组,差异有统计学意义(P<0.05)。治疗结束时,两组的疼痛、麻木、触电感VAS评分分别与各自牵引结束时的变化均不大,差异无统计学意义(P>0.05);NTP组患者疼痛、肢体麻木及触电感的VAS评分(1.3±0.98)分、(1.8±0.86)分、(0.5±0.49)分仍分别小于对照组(2.6±0.49)分、(2.9±1.26)分、(1.8±0.76)分,差异均有统计学意义(P<0.05)。20例至解除石膏固定时,颈椎力线均恢复,颈椎稳定,无颈椎不稳定、肺炎、褥疮等并发症的发生。Frankel分级A级的3例中2例为NTP治疗,1例为非NTP治疗,治疗后均获不同程度的改善,其中2例改善至C级,1例改善至D级。结论NTP结合保守牵引治疗可以有效减轻患者的颈椎过伸伤患者的神经症状,明显改善患者疼痛、肢体麻木及触电感。Objective To explore the preliminary clinical effects of extrace from inlfammatory cutaneous tissues of the rabbit inoculated with vaccina virus, also called Neurotropin （ NTP ） in the treatment of hyperextension injuries of cervical spinal cord. Methods From January 2010 to January 2014, 20 patients with hyperextension injuries of cervical spinal cord were adopted, who were randomly divided into the NTP group and the control group. Traction was performed on the patients in the NTP group for 3 weeks and then plaster ifxation for 3 months, besides the NTP treatment. Occipital-jaw-traction was performed on the patients in the control group for 3 weeks and then plaster fixation for 3 months. The Visual Analogue Scale （ VAS ） was used to assess pain, limb numbness and electrified sensation in both groups, and the scores before the treatment and at the end of traction and treatment were recorded and compared. Results The VAS scores of pain, limb numbness and electriifed sensation in the NTP group were （ 6.2±1.81 ） points, （ 5.3±1.15 ） points and （ 5.4±0.84 ） points before the treatment, which were obviously reduced to （ 1.2±0.78 ） points, （ 1.6±0.84 ） points and （ 0.6±0.51 ） points at the end of traction. The differences between them were statistically signiifcant （ P0.05 ）. The VAS scores of pain, limb numbness and electriifed sensation in the NTP group were （ 1.3±0.98 ） points, （ 1.8±0.86 ） points and （ 0.5±0.49 ） points at the end of treatment, which were respectively lower than （ 2.6±0.49 ） points, （ 2.9±1.26 ） points and （ 1.8±0.76 ） points in the control group. The differences between them were statistically signiifcant （ P〈0.05 ）. Cervical spine alignment was restored in all the patients when the plaster was removed, and the cervical spine was stable. No cervical unstability, pneumonia or bedsore occurred. According to the Frankel grading system, 2 of the 3 patients rated as grade A underwent NTP treatment, and the last one did not. T

关 键 词：椎间盘移位 颈椎 治疗结果 药物疗法 

分 类 号：R651.2[医药卫生—外科学]