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作 者:蒋春闪 张磊峰 程向前 JIANG Chunshan;ZHANG Leifeng;CHENG Xiangqian(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出 处:《中国医学创新》2022年第27期10-14,共5页Medical Innovation of China
摘 要:目的:分析前路减压复位融合内固定术联合神经节苷脂在急性颈脊髓损伤中的应用效果。方法:选取2018年6月-2021年1月于徐州医科大学附属医院接受治疗的急性颈脊髓损伤患者80例为研究对象,使用随机数字表法将患者分为前路减压组及联合减压组,各40例。前路减压组单进行前路减压复位融合内固定术治疗,联合减压组在前路减压组基础上增加神经节苷脂治疗。对两组治疗前后的脊髓损伤ASIA的运动及感觉指数评分表(ASIA)、日常生活能力量表(ADL)评分进行对比,对两组治疗前后的肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)的水平和恢复情况进行比较。结果:治疗后3、6及12个月,联合减压组ASIA评分均高于前路减压组(P<0.05);治疗1个月后的联合减压组的躯体生活自理表(PSMS)、工具性日常生活活动量表(IADL)评分均低于前路减压组(P<0.05);治疗1个月后,与前路减压组相比,联合减压组血清TNF-α、IL-1β水平均较低(P<0.05);治疗1个月后,与前路减压组相比,联合减压组优良率较高(P<0.05)。结论:前路减压复位融合内固定术联合神经节苷脂对急性颈脊髓损伤进行治疗,可提高患者感觉及运动功能,改善其生活能力,减轻脊髓和神经元的损伤,治疗效果显著。Objective:To analyze the effect of anterior decompression reduction and fusion internal fixation combined with Ganglioside in acute cervical spinal cord injury.Method:Eighty patients with acute cervical spinal cord injury treated in Affiliated Hospital of Xuzhou Medical University from June 2018 to January 2021 were selected for the study,and the patients were divided into anterior decompression group and combined decompression group using the random number table method,with 40 cases each.The anterior decompression group was treated with anterior decompression reduction and fusion internal fixation alone,while the combined decompression group was treated with Ganglioside on top of the anterior decompression group.The ASIA and ADL scores of the two groups were compared before and after treatment,and the levels of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)and recovery of the two groups were compared before and after treatment.Result:After 3,6 and 12 months of treatment,the ASIA scores in the combined decompression group were higher than those in the anterior decompression group(P<0.05);after 1 month of treatment,the physiscal self-maintenance scale(PSMS)and instrumental activities of daily living scale(IADL)scores in the combined decompression group were lower than those in the anterior decompression group(P<0.05);after 1 month of treatment,compared with the anterior decompression group,the serum TNF-αand IL-1βlevels in the combined decompression group were lower(P<0.05);after 1 month of treatment,the excellent rate in the combined decompression group was higher compared with the anterior decompression group(P<0.05).Conclusion:The treatment of acute cervical spinal cord injury with anterior decompression reduction and fusion internal fixation combined with Ganglioside can improve patients’sensory and motor functions,improve their living ability,and reduce the damage to the spinal cord and neurons,with significant therapeutic effects.
关 键 词:急性颈脊髓损伤 前路减压复位融合内固定术 神经节苷脂 水平移位
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