间断甲泼尼龙琥珀酸钠治疗颈脊髓损伤伴不全瘫的临床疗效及安全性评价  

Clinical efficacy and safety of intermittent methylprednisolone in the treatment of cervical spinal cord injury with partial paralysis

作　　者：徐成[1] 张立岩[1] 

机构地区：[1]温州医科大学附属第六医院骨科,浙江丽水323000

出　　处：《中国临床药理学杂志》2015年第9期702-704,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省医药卫生一般研究计划基金资助项目(2012KYB251)

摘　　要：目的：评价间断甲泼尼龙琥珀酸钠治疗颈脊髓损伤伴不全瘫的临床疗效及安全性。方法颈脊髓损伤伴不全瘫患者61例随机分为试验组32例和对照组29例。对照组根据脊髓受压程度实施椎体减压及植骨融合内固定手术，试验组在对照组治疗的基础上给予甲泼尼龙琥珀酸钠治疗，受伤＜3h患者给予甲泼尼龙琥珀酸钠30 mg· kg－1· h－1，静脉滴注15 min，间隔45 min给予甲泼尼龙琥珀酸钠5.4 mg· kg－1· h－1，持续静脉滴注23 h。伤后3～8 h者，首用剂量相同，持续静脉滴注48 h。1个月后，比较2组患者的临床疗效，日本骨科协会（ JOA）和药品不良反应。结果试验组与对照组的治愈率分别为46.9％（15／32）和20.7％（6／29），试验组治愈率显著高于对照组（P＜0.05）。治疗后，2组患者的日本骨科协会（ JOA）评分均较治疗前显著提高，且试验组评分显著高于对照组（ P＜0.05）。2组患者总不良反应发生率分别为15.6％和17.2％，差异无统计学意义（ P＜0.05）。结论间断甲泼尼龙琥珀酸钠治疗颈脊髓损伤伴不全瘫的疗效确切，不良反应发生率低。Objective To study the clinical efficacy and safety of intermittent methylprednisolone in the treatment of cervical spinal cord injury with partial paralysis.Methods A total of 86 cases with cervical spinal cord injury and partial paralysis were recruited in our study and randomized divided into experiment group （ n =32 ） and control group （ n=29 ）.Patients in the control group received spinal cord compression based on the degree of implementation of the vertebral decompression and internal fixation of bone fusion.Patients in the experiment group were given methylprednisolone intermittent treatment on the basis of control group.For patients within 3 hours after injury, methylprednisolone 30 mg· kg-1 · h-1 were given through intravenous drop for 15 min, with interval 45 minutes then 5.4 mg· kg-1 · h-1 was given through intrave-nous drop for 23 h, and for patients within 3 to 8 hours after injury, the first dosage was the same and lasted for 48 h.Results The cure rate was 46.9%（ 15/32 ） and 20.7%（ 6/29 ） in the experiment and control group, respectively （ P 〈0.05 ）.The Japanese orthopedic association （ JOA） score was significantly improved in two groups after treatment and the JOA score in the experiment group was significantly higher than that＆amp;nbsp;in control group （ P〈0.05）.The rate of total adverse drug reactions was 15.6% and 17.2%in the experiment and control group, respectively, but without statistical difference （ P〉0.05）.Conclusion Intermittent methylprednisolo-ne for the treatment of cervical spinal cord injury combined partial paralysis is effective with less adverse drug reactions.

关 键 词：甲泼尼龙琥珀酸钠 脊髓损伤 不全瘫 临床疗效 安全性 

分 类 号：R744[医药卫生—神经病学与精神病学] R977.1[医药卫生—临床医学]