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《腰椎管狭窄症手术中应用大剂量甲基强的松龙对神经的保护作用》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、fJ康复理沦j实践2010年9川第l6巷第9期ChinJRehahilTheoryPratt,Sep1.2010,Vo1.16,No.9·临床研究·腰椎管狭窄症手术中应用大剂量甲基强的松龙对神经的保护作用张华,赵治国,姚春丽[摘要]目的探心椎竹狭窄Jr术治疗}l大剂强的松尼(MP)对-脊髓的保护作用。方法脞椎僻狭窄-患2O例,均采用单纯后路腰椎板切除术。渝疗纰11例,于切开皮肤时静脉给MI30mg/kg;术后静脉脯』tJMP40rag/次,2次/d,共3d。对照组9例,术rll/f他』}JMP,小后静脉给MP40rag/次,2次/d,3d。』L}』JOA评分评价两组患并术丽币¨术卒
2、咔f经功能情况。结果治疗绀及则照术前JOA评分分别为(9.25±2.12)分和(9.53±2.10)分(P>0.05)。术l用【fl『治疗j对照签lJ()A评分分别为(13.43±2.01)分干¨(11.21±2.13)分;3个月时JOA评分分别为(】4.62±2.15)分干¨(13.04±2.11).治疗纰均优于对照(,J3、oneforNeuralProtectioninOperationforLumbarSpinalStenosisZHANGHua.ZHAOZhi-guo,YAOCh“"li.BeilinRed(?rossHospilal,Xi'an710001,Shaan.ri,(^inaAbstract:ObjectiveToobservetheprotectiveeffectofhighdosagemethylpredniso1onc(MI’)afterlumbarspinalstenosisoperation.Methods20Patientswithlumbarspinalstenosis4、acceptedlaminectomy.Thetreatmentgroup(1lcases)receivedMP30mg/kgwhentheskinincised,andfollowedwithMP40mgtwiceadayfor3dafteroperation.Thecontrolgroup(9cases)receivedMP40mgtwiceadayfor3dafteroperation.TheywereassessedwithJ()Ascalebeforeandafteroperation.ResultsI'heJOAscorewas(9.25±2.12)and(9.53±25、.10)intreatmentgroupandcontrolgroupbeforeoperation(P>0.05),andwas(13.43±2.01)and(11.21±2.13)1weekafteroperation(P<0.05),(14.62±2.15)and(13.04±2.11)3monthsafteroperation(j’<0.05).Theneurologicalsymptomdeterioratedin1casesofcontrolgroup.Nopepticulcer.poorwoundhealingorotherassociatedcomplication6、shasbeenfound.ConclusionHigh—dosagemethy1prednis()l()ncmayprotectthespinecordintraoperativethelumbarspinalstenoSls.Keywords:1umbarspinalstenosis;methylpre[1nis()lone;spinalcord;protection[中图分类号]R681.5[文献标识码]A[文章编号]1006—977l(2olo)09086502[本文著录格式]张华.赵治,姚夼.腰椎铃狄窄于术一},腑川大剂齄}}t啦的松龙对神经的护作/lJEJ].1iI康复7、沦j实践,201o,16(9):865866.应用大剂甲基强的松龙(mythylpredniso1one,症;②并发脑部疾患、颈椎病或腰段脊髓或神经根病变MP)冲击治疗急性脊髓损伤可在一定程度上保护和促影响下肢功能者;③X线、磁共振榆查显示腰椎畸形进脊髓神经功能恢复u。构成腰椎管的任何组织结构者。根据患者或家属是否同意应用MP分为两组:治发生瘸变,致使椎管容积变小而压迫脊髓神经都可能疗绀11例,男性5例,女性6例;年龄48~63岁,平均导致腰椎管狭窄症(1umbars
3、oneforNeuralProtectioninOperationforLumbarSpinalStenosisZHANGHua.ZHAOZhi-guo,YAOCh“"li.BeilinRed(?rossHospilal,Xi'an710001,Shaan.ri,(^inaAbstract:ObjectiveToobservetheprotectiveeffectofhighdosagemethylpredniso1onc(MI’)afterlumbarspinalstenosisoperation.Methods20Patientswithlumbarspinalstenosis
4、acceptedlaminectomy.Thetreatmentgroup(1lcases)receivedMP30mg/kgwhentheskinincised,andfollowedwithMP40mgtwiceadayfor3dafteroperation.Thecontrolgroup(9cases)receivedMP40mgtwiceadayfor3dafteroperation.TheywereassessedwithJ()Ascalebeforeandafteroperation.ResultsI'heJOAscorewas(9.25±2.12)and(9.53±2
5、.10)intreatmentgroupandcontrolgroupbeforeoperation(P>0.05),andwas(13.43±2.01)and(11.21±2.13)1weekafteroperation(P<0.05),(14.62±2.15)and(13.04±2.11)3monthsafteroperation(j’<0.05).Theneurologicalsymptomdeterioratedin1casesofcontrolgroup.Nopepticulcer.poorwoundhealingorotherassociatedcomplication
6、shasbeenfound.ConclusionHigh—dosagemethy1prednis()l()ncmayprotectthespinecordintraoperativethelumbarspinalstenoSls.Keywords:1umbarspinalstenosis;methylpre[1nis()lone;spinalcord;protection[中图分类号]R681.5[文献标识码]A[文章编号]1006—977l(2olo)09086502[本文著录格式]张华.赵治,姚夼.腰椎铃狄窄于术一},腑川大剂齄}}t啦的松龙对神经的护作/lJEJ].1iI康复
7、沦j实践,201o,16(9):865866.应用大剂甲基强的松龙(mythylpredniso1one,症;②并发脑部疾患、颈椎病或腰段脊髓或神经根病变MP)冲击治疗急性脊髓损伤可在一定程度上保护和促影响下肢功能者;③X线、磁共振榆查显示腰椎畸形进脊髓神经功能恢复u。构成腰椎管的任何组织结构者。根据患者或家属是否同意应用MP分为两组:治发生瘸变,致使椎管容积变小而压迫脊髓神经都可能疗绀11例,男性5例,女性6例;年龄48~63岁,平均导致腰椎管狭窄症(1umbars
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