甲基强的松龙在脊髓型颈椎病围手术期应用的临床分析

Clinical analysis of the application of mythylprednisolone in treatment of cervical spondyrlotic myelopathy(CSM) during operative period

目的观察甲基强的松龙对脊髓型颈椎病患者术后神经功能的影响。方法2005年9月～2007年9月对20例脊髓型颈椎病患者行颈椎前路减压手术,并于围手术期应用甲基强的松龙（治疗组）;对照组23例脊髓型颈椎病患者仅行前路减压手术。观察两组患者术前和术后3d、2周、3个月分别用JOA评分标准对患者神经功能评分,记录应用甲基强的松龙的相关并发症发生情况。结果术前各组患者JOA评分无统计学差异（P〉0.05）;术后3d、2周和3个月时,治疗组JOA评分分别为（11.1±3.2）分、（12.6±2.3）分、（14.2±4.0）分,较对照组高,差异有统计学意义（P〈0.05）。结论颈脊髓减压前30min快速静脉滴注甲基强的松龙1000mg,术后lh开始静脉滴注甲基强的松龙80mg,每日2次,连续使用5d能够显著改善脊髓型颈椎病患者术后近期的神经功能。

Objective To evaluate the effects of methyloprednisonlone （MP） on the neurological functions of cervical spondyrlotie myelopathy（CSM） during peritoperative period. Methods Twenty patients with CSM in the control group underwent anterior decompression only, yet 23 patients with CSM in the experiment group obtained additional MP perioperatively during January 2005 - January 2007. The patients neurological functions were graded according the JOA SCORE system preoperatively and in 3 day,2 weeks and 3 months postoperatively. Complications were recorded during the application of MP. Results Preoperative JOA SCORES among each group had no statistical difference （P 〉 0.05 ） ; The JOA SCORES of test group post surgically were 11.1±3.2,12.6±2.3 and 14.2±4.0 respectively, which were higher than in the control group （ P 〈 0.05 ）. Conclusions Intravenous application of 1000 mg MP 30 min before surgery and 80 mg MP （intravenously） , bid for 5 days postoperatively, can improve short-term postoperative neural function significantly.