手术联合NGF治疗无骨折脱位型颈脊髓损伤的临床疗效分析

Analysis on the Clinical Effect of Surgery Combined with NGF in the Treatment of Cervical Spinal Cord Injury Without Fracture and Dislocation

目的探讨与评价早期手术联合神经生长因子(NGF)治疗无骨折脱位型颈脊髓损伤的临床疗效。方法调取2010年1月至2014年12月我院确诊的58例无骨折脱位型颈脊髓损伤患者的临床诊治资料和随访效果进行回顾性分析,以早期手术治疗及NGF的应用为切入点,将病例分传统保守治疗、保守联合NGF治疗、手术治疗以及手术联合NGF治疗等四组进行比较,采用JOA评分法评定颈脊髓神经功能恢复状况,分析比较治疗前,以及治疗后1周、4周、12周及12个月的JOA评分改善率,评价诊治效果。结果无论患者是否采取早期手术减压,相比较于未使用NGF组,应用NGF组在治疗4周、12周及12月后均能得到更佳的JOA评分改善率(P<0.05);其中手术治疗组JOA评分改善率与非手术治疗组存在显著差异(P<0.05),手术联合NGF治疗组疗效最优,1年后JOA改善率为83.41%,临床疗效显著。结论 NGF治疗无骨折脱位型颈脊髓损伤有一定疗效,而早期手术联合使用NGF治疗可获得更佳的颈脊髓神经功能恢复。

Objective To study and evaluate the curative effect of early surgery combined with nerve growth factor（NGF） for the treatment of cervical spinal cord injury without fracture and dislocation. Methods From January 2010 to December 2014,58 cases of patients with cervical spinal cord injury without fracture and dislocation were analyzed retrospectively to compare the clinical effect. These cases were divided into 4 groups by the different treatments with or without administration of NGF and early surgery. The JOA score improvement rate of the curative effect was valued and compared among 4 groups in the time after treatment for 1 week,4 weeks,12 weeks,and 12 months. Results A significant difference was noted on the JOA score improvement rate after treatment for 4 weeks,12 weeks,and12 months not only between the conventional conservative treatment group and the NGF group（P〈0.05）,but also between the early surgery treatment group and the early surgery with NGF group（P〈0.05）. The JOA score improvement rate in the early surgery group was better than that in the non-surgery group（P〈0.05）. The best JOA score improvement rate（83.41% for 12 months） was in the group of early surgery with NGF. Conclusions The curative effect of using NGF to treat the cervical spinal cord injury without fracture and dislocation is distinguished.A further functional recovery of cervical spinal cord may be gained by the administration of NGF and early surgery.