腰神经根减压术后应用倍他米松联合医用生物蛋白胶治疗腰椎间盘突出症患者的临床研究  

Clinical study on application of betamethasone combined with biomedical fibrin glue in treatment of patients with lumbar intervertebral disc protrusion after nerve root decompression of lumbar vertebra

作　　者：孙志杰[1] 张义龙[1] 孙贺[1] 刘正蓬[1] 王雅辉[1] 

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《颈腰痛杂志》2017年第2期111-114,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨腰神经根减压术后应用倍他米松联合医用生物蛋白胶治疗腰椎间盘突出症患者的临床效果。方法选取120例需行腰神经根减压术治疗的腰椎间盘突出症患者采用随机数字表法分为3组,分别为倍他米松组、生物蛋白胶组及联合组,各40例。上述各组均依次给予倍他米松、生物蛋白胶、倍他米松联合医用生物蛋白胶干预。观察对比术后48 h内引流量、术后2周切口愈合和神经根粘连情况、术后不同时刻VAS和ODI评分。结果联合组术后48 h内引流量、神经根粘连发生率明显低于倍他米松组和生物蛋白胶组(P<0.05),术后2周切口甲级愈合率显著高于倍他米松组和生物蛋白胶组(P<0.05);3组VAS和ODI评分比较差异均有统计学意义(P<0.05),且术后8 h、12 h、2周和1个月联合组VAS评分均较倍他米松组和生物蛋白胶组数据显著降低(P<0.05),术后1周、1个月和3个月联合组ODI评分均较倍他米松组和生物蛋白胶组显著降低(P<0.05)。结论腰神经根减压术后应用倍他米松联合医用生物蛋白胶治疗腰椎间盘突出症患者可显著减轻术后疼痛、改善腰椎功能、降低神经根粘连发生率。Objective To explore the clinical effect of betamethasone combined with biomedical fibrin glue in treatment of patients with lumbar intervertebral disc protrusion after nerve root decompression of lumbar vertebra. Methods One hundred and twenty patients with lumbar intervertebral disc protrusion who were treated with nerve root decompression of lumbar vertebra were selected. And the patients were divided into betamethasone group, fibrin glue group and combination group according to the random digital table method, forty cases in each group. The patients in three groups were given betamethasone, biomedical fibrin glue and betamethasone combined with biomedical fibrin glue, respectively. The postoperative 48 h internal drainage, 2 weeks after the operation, the wound healing and nerve root adhesion, the scores of VAS and ODI at different moments after operation in the two groups were observed and compared. Results The postoperative 48 h internal drainage and incidence rate of nerve root adhesion in the combination group were obviously lower than those in the betamethasone group and fibrin glue group （P〈0.05）, while the grade A healing rate of 2 weeks after operation was significantly higher than that in the betamethasone group and the fibrin glue group （P〈0.05）. The differences were statistically significant in scores of VAS and OD1 among the three groups （P〈0.05）, and VAS scores at 8 h, 12 h, 2 weeks and 1 month after operation in the combination group significantly decreased compared with those in the betamethasone group and the fibrin glue group （P〈0.05）, and ODI scores at 1 week, 1 month and 3 months after operation significantly decreased compared with those in the betamethasone group and the fibrin glue group （P〈 0.05）. Conclusion Betamethasone combined with biomedical fibrin glue in the treatment of patients with lumbar intervertebral disc protrusion after nerve root decompression of lumbar vertebra can significantly reduce postoperative pain, improve the function of lumbar spin

关 键 词：腰神经根减压术 倍他米松 医用生物蛋白胶 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]