甲基强与松龙在伴有严重脊髓压迫与颈椎疾患减压术中与应用.docVIP

甲基强的松龙在伴有严重脊髓压迫的颈椎疾患减压术中的应用 陶春生 倪 斌 王 健 王明飞 （上海长征医院骨科，200003） 摘要：目的 探讨适量甲基强的松龙（Methylprednisolone MP）在伴有严重脊髓压迫颈椎疾患减压手术中的应用价值。方法 选取伴有严重脊髓压迫的颈椎疾患38例，随机分为治疗组和对照组。治疗组20例在减压术前及术后使用适量MP治疗。对照组18例施行同样减压术但未使用MP治疗。以JOA脊髓功能评定和相关并发症发生率作为标准进行对比研究。结果 使用适量MP的治疗组减压后JOA评分与对照组相比，两者有显著差异（P﹤0.01）。并发症发生率比较显示两组均无差异（P0.5）ethylprednisolone in decompression procedure of the cervical spondylosis with spinal cord compressed severely/TAO Chunsheng,NI Bin/ 【Abstract】Objective:To discuss the value of methylprednisolone applied in decompression procedure of the cervical spondylosis with spinal cord compressed severely.Method:38 cases of cervical spondylosis with spinal cord compressed severely were selected in this research.20 cases of those randomly selected were treated with sufficient quantum methylprednisolone before and after decompression procedure. 18 cases were treated by the same operation without methylprednisolone as a control. divided into treatment group and control group.Comparison of two groups was studied by functional evaluation of spinal cord(established by Japan orthopaedic association JOV) and incidence rate of cmplications related to MP.Result:JOV grade of treatment group compared with control group had.However,comparison of complication had no significant deviation(P0.5).Conclusion: Administering ufficient quantum methylprednisolone before and after decompression procedure can significantly improve spinal cord function,and complications related to MP are infrequent. 众所周知，目前甲基强的松龙在急性脊髓损伤的治疗中应用较广，实验及临床研究表明，大剂量甲基强的松龙对急性脊髓损伤的治疗具有一定的作用，可以在有限的时间内，保护和促进一定限度内脊髓功能的恢复。但，对甲基强的松龙在脊髓慢性损伤减压术后的治疗效果尚缺乏临床与基础研究。本手术组对20例伴有严重脊髓压迫的颈椎疾患在进行减压术前及术后分别使用适量甲基强的松龙处理，与未使用该药物处理的同样18例病例进行临床对比研究，发现术前及术后使用适量甲基强的松龙处理具有明显改善术后脊髓神经功能的作用，且显著并发症比较少见。 1 资料与方法 1.1 病例收集 收集本手术组2004年1～12月伴有严重脊髓压迫的颈椎疾患并拟行颈椎减压术的患者38例，疾病类型包括Chiari畸形8例，陈旧性寰枢椎脱位12例，后纵韧带骨化症10例，巨大颈椎间盘突出4，颈椎管内良性肿瘤4例。随机分为治疗组（20例）和对照组（18例）。 1.2 入组标准 (1)年龄24～65岁；(2)术前JOA评分≤9分；和或脊髓矢状径≤0.5cm；(3)无显著肝、肾和心血管系统功能损害；(4) 无消化道溃疡病史。 1.3 治疗方法 根据不同