弥可保对断指再植后感觉恢复的疗效评价

Effect of Methycobal on sensory recovery after finger replantation

目的探讨弥可保(甲基维生素B_(12))对周围神经损伤患者的感觉神经再生作用并对比不同剂量弥可保的神经再生作用。方法将62例81指近节断指再植术后的病例,根据急诊病历号随机分为3组：A组：弥可保1500μg肌肉注射,每日1次,共30次后改为500μg口服,每日3次,共4个月。B组：弥可保500μg肌肉注射,每日1次,共30次后改为500μg口服,每日3次,共4个月。C组：阴性对照组。术后随访4～6个月,平均随访5．6个月。定期测定再植手指指腹的30 g压觉,2 g触觉,5 g痛觉以及两点分辨觉。结果3组对照,实验组手指感觉功能恢复均明显优于阴性对照组,1500μg弥可保组感觉功能恢复显著优于500μg弥可保组。结论弥可保对周围神经损伤后的恢复有促进作用,且与药物的剂量呈正相关。

Objective To investigate the effect ＂of methyl＂ VitB,2 （Methycobal） on promoting sensory nerve regeneration after peripheral nerve injury and to compare the effect of different dosages of Methycobal. Methods 62 eases with a total of 81 finger replantation were involved in the study. The patients were randomly divided into 3 groups. In Group A 1 500μg Methycobal was given intramuscularly once a day for the first month and then 500 μg orally 3 times a day for the following 4 months. In Group B 500 μg Methycobal was given intramuscularly once a day for the first month and then 500μg orally 3 times a day for the following 4 months. Group C was control group. All patients were followed for 4 to 6 months, with an average of 5.6 months. Patients were tested regularly for the appearance of sensation of pressure at 30 g, tactile sensation at 2 g, sensation of pain at 5 g and two-point discrimination. Results All parameters tested were better in the Methycobal treated groups than in the control group. Better recovery of sensation was also observed in the 1 500μg group than in the 500μg group. Conclusion Methycobal can promote peripheral nerve regeneration. This effect is dose related.