颈椎手术中及术后应用甲基强的松龙临床疗效研究

Effect of application of methylprednisolone on intraoperative and postoperative cervical vertebra operation

目的研究术中及术后应用甲基强的松龙对颈椎病患者术后近期疗效的影响。方法郑州大学第一附属医院骨科自2011年6月至2013年1月收治的需手术治疗的颈椎病患者共80例,随机分为A、B两组。A组为实验组共40例,给予常规颈椎手术治疗,术中给予甲基强的松龙30mg/Kg静脉滴注,并于15min内快速滴注。术后每天给予甲基强的松龙80mg静脉滴注,连用3d。B组为对照组共40例,给予常规颈椎手术治疗,术中、术后均无甲基强的松龙应用。A、B两组患者其他治疗相同,均给予常规术前及术后处理。结果两组患者术前1d和术后1d JOA评分无统计学差异(P>0.05)。术后3d、1w、2w、4w A、B两组JOA评分比较P=0.00,具有统计学意义(P<0.05)术后8w、12w A、B两组JOA评分P值分别为0.171和0.459,无统计学差异(P>0.05)。结论术中及术后合理应用甲基强的松龙可使颈椎病患者手术后更快的恢复神经功能。

Objective To study the effect of the applicationg of methylprednisolone （NIP）intraoperative and postoperative cervical vertebra loperation. Methods Totally 80 patients with cervical spondylosis, need surgical treatment, from June 2011 to January 2013 in our department,divided into two groups. Group A,experimental group,given MP 30mg/Kg by in- travenousUy guttae within 15min during the operation and given MP 80mg once a day for three days after operation~ Group B, control group, given common operation without MP. The neurological function was evaluated before the operation and 1 d, 3d,lw,2w,4w,8w, 12w after the operation by Japanese Orthopeadic Association score （JOA）,then the analysis was taken. Results There was no difference between the two groups 1 d before operation and 1 d after operation （P 〉 0. 05 ） There was a significant difference on 3d, 1 w,2w,4w after operation （P 〈 0. 05 ）. While the difference was not obvious on 8w and 12w after operation （P 〉 0. 05） ,as the P = 0. 171 on 8w and P = 0. 459 on 12w. Conclusion The application of methylprednisolone intraoperative and postoperative cervical vertebra operation lead to faster recovery of nerve function