甲泼尼龙在胸髓损伤手术治疗中的应用

Application of Methylprednisolone in Operative Treatment of Thoracic Spinal Cord Injury

目的探讨甲泼尼龙在胸髓损伤围术期的应用及疗效。方法将41例胸椎骨折并脊髓损伤患者随机分为治疗组与对照组,其中治疗组21例,对照组20例。治疗组在围术期应用甲泼尼龙进行脊髓保护;对照组仅行手术治疗。两组患者治疗前和治疗后2周、3个月、1年分别采用日本骨科学会脊髓功能评定标准(JOA评分法)进行神经功能评分。同时记录应用甲泼尼龙的相关并发症发生情况。结果治疗前两组患者JOA评分差异无统计学意义(P>0.05);治疗后2周、3个月和1年时,治疗组JOA评分分别为(8.00±1.30)、(9.29±1.42)、(11.24±2.02)分,较对照组高,且差异有统计学意义(P<0.05)。结论胸椎骨折并脊髓损伤患者在围术期应用甲泼尼龙,能有效保护脊髓,显著改善神经功能。

Objective To explore the effects of methylprednisolone（ MP）in operative treatment of Thoracic spinal cord injury. Methods In treatment group,MP was given to protect spine cord in 21 cases with Thoracic spinal cord injury during operative period;in control group ,20 patients were treated only by surgery. Japanese Orthopedic Association（JOA）score system was adopted to evaluate spine cord function recover）, or improvement before treatment and at,2 week,3 month, 1 year after treatment. The complications related to MP were recorded. Results There was no significiant difference between two groups before therapy（P 〉 0.05 ）. At two week, three month, one year after treatment, JOA score were 8.00 ± 1.30,9.29 ± 1.42,11.24± 2.02,which was significiant different compared with control group（ P 〈 0.05 ）. Conclusion It is an effective way to protect spine cord and improve function recovery that use MP in operative treatment of Thoracic spinal cord injury