探讨地塞米松治疗剖宫产术硬膜外穿刺神经根损伤的安全性及临床效果

Investigation on safety and clinical efficacy of dexamethasone treating cesarean delivery epidural puncturing nerve root injury

目的探讨剖宫产术中应用地塞米松治疗硬膜外穿刺神经根损伤的安全性及临床效果。方法选取2011年1月至2013年1月本院妇产科择期硬外膜麻醉下行剖宫产术穿刺过程中神经根损伤的患者90例为研究对象,根据临床治疗方案的不同分为治疗组与对照组,根据地塞米松使用剂量不同将治疗组分为治疗A组与治疗B组。观察三组患者治疗72小时后神经根及神经刺激症状发生情况、疗效及治疗期间不良反应发生情况。结果治疗72小时后,三组患者神经根及神经刺激症状发生率比较差异具有显著性(P<0.05);对照组治疗总有效率显著低于治疗A组和治疗B组,差异具有显著性(P<0.05),治疗A组和治疗B组比较差异无显著性(P>0.05)。治疗A组和治疗B组分别有2例患者出现呃逆,治疗B组1例患者出现腹胀、乏力症状,对照组患者2例出现腹胀、乏力等症状,调整剂量后上述症状得到缓解,不影响本研究结果。结论采用地塞米松治疗剖宫产术硬膜外穿刺神经根损伤临床效果显著,无严重不良反应发生,值得临床推广应用。

Objective To investigate the safety and clinical efficacy of dexamethasone to treat caesarean epidural puncturing nerve root injury. Method 90 cases of nerve root injury from January 2011 to January 2013 in our hospital undergoing epidural anesthesia for cesarean section in the process of puncturing patients as the research objects. According to the different clinical treatment they were divided into treatment group and control group, according to the different dose of dexamethasone in the treatment group were divided into treatment group A and treatment group B. Three groups were observed after 72 hours of treatment of nerve root and nerve stimulation symptoms, efficacy and adverse reactions. Result 72 hours after treatment, three groups of patients with nerve root and nerve stimulation symptom incidence of differences between groups was significant（P〈0.05）; after treatment, the total efficiency of control group were significantly lower than that of treatment group A and treatment group B, the difference was significant（P〈0.05）, treatment of A group and treatment group B had no significant difference（P〉0.05）. Treatment group A and treatment group B were 2 cases of patients with hiccup, treatment group B 1 patients with abdominal distention, fatigue, abdominal distention, 2 cases of control group patients with fatigue and other symptoms, dose adjustments after the symptoms have been alleviated, does not affect the results of this study. Conclusion Dexamethasone treating cesarean epidural puncturing nerve root injury is worthy of clinical application.