改良SD疗法治疗Bell麻痹

Effects of modified SD therapy on Bell′s palsy

目的 :探讨改良后的静脉大剂量氢化考的松与低分子右旋糖酐 (SD疗法 )治疗 Bell麻痹 (BP)的疗效 ,避免 SD疗法中出现的并发症。方法 :以改良 SD疗法治疗 BP患者 71例 (改良组 ) ,以口服类固醇激素治疗 32例BP患者作对照 (对照组 )。比较改良 SD疗法与文献中 SD疗法的疗效及出现的并发症的比率 ,比较改良组与对照组的疗效。结果 :BP患者 House- Brackmann ～ 级恢复率 ,改良组为 95 .8% ,对照组 81.2 % (P <0 .0 5 ) ;改良组的 71例中 ,发病后 2 4h内接受治疗者 I级恢复率为 75 .0 % ,2 4～ 48h为 43.8% ,2～ 3 d为 2 6 .7% ,3～ 5 d为18.8% ,第 1个时段者与其后 3个时段者比较 ,差异均有显著性意义 (P <0 .0 5 ) ;且无肝肾功能损害及消化道溃疡发生。结论 :于发病后 2 4h内进行改良 SD疗法 ,能提高 BP患者 ～ 级恢复率 ,缩短恢复时间 ,能避免原疗法中出现的肝肾功能损害及消化道溃疡等严重并发症。

Objective:To investigate the effects of a modified SD therapy(intravenous high dose hydrocortisone and low molecular dextran)on Bell′s palsy(BP), and to avoid the severe side effects such as hepatic and renal disorders during the treatment.Method:Seventy one BP patients were treated with modified SD method (modified group), thirty two BP patients took prednisone (control group), and the curative rates of two therapies were compared, in the meanwhile recorded the side effects in detail.Result:Curative rate in modified group was 95.8 % (House Brakmsnn Ⅰ～Ⅱ) and in control group was 81.2 % (P< 0.05 ). In modified group, the curative rate (Ⅰ grade) in the patients were treated within 24 hours following onset was 75.0 %, and the curative rate in other three subgroups were treated within 24～48 hours,2～3 day and 3～5 day following onset was 43.8 %, 26.7 %, 18.8 % respectively. Modified group had not shown hepatic and renal disorders or gastric ulcer.Conclusion:Modified SD method may increase recoverable rate and can avoid significant side effects for BP, and emphasizes the importance of the administration of SD therapy in the early stage of the disease.