连续硬膜外腔置管治疗老年腰椎间盘突出症临床研究

Clinical study of treating lumbar disc herniation in the elderly by continuous epidural catheter

目的:观察不同剂量的甲强龙经硬膜外腔泵注治疗老年腰椎间盘突出症的临床效果。方法:腰椎间盘突出症的老年患者60例随机分为5 mg/d甲强龙组(A组)、10 mg/d甲强龙组(B组)、15 mg/d甲强龙组(C组),每组20例,经连续硬膜外腔置管治疗1周,观察VAS评分、Macnab、血清IL-6、血糖的改变情况。结果:B、C两组VAS评分较A组明显降低,优良率较高(P<0.05),B、C两组比较差异无统计学意义(P>0.05);C组治疗过程中血糖值波动较大,A、B两组治疗前后差异无统计学意义(P>0.05)。3组血清IL-6较治疗前降低(P<0.05)。结论:10mg/d甲强龙可有效治疗老年椎间盘突出症,能够较好缓解患者症状,并且治疗过程中血糖波动较小。

Objective：To observe the clinical effect of different doses of methylprednisolone epidural infusion in treating elderly lumbar disc herniation. Methods： 60 cases with elderly lumbar disc herniation,randomized into 5 mg /d methylprednisolone group（A）, 10 mg /d methylprednisolone group（B）and 15 mg /d methylprednisolone groups（C）, with 20 cases each group, through continuous epidural catheter one week of treatment. VAS score, Macnab changes and IL-6 blood、sugar were bserved. Results： B, C groups VAS scores were significantly lower,but excellent rate was higher than that in group A（P 0.05）,B, C groups were no different（P 0.05）, group C during the treatment blood sugar level was fluctuations,A, B groups were no significant before and after the treatment（ P 0.05）,serum interleukin-6 in three groups compared to before treatment was significantly lower（ P 0.05）. Conclusion：10 mg/d methylprednisolone may be effective in treating disc herniation in the elderly, better able to alleviate the symptoms and with the smaller blood sugar fluctuation.