摘要
ObjectiveTo 在经皮的内视镜的腰部的 discectomy (PELD ) 期间估计类固醇的硬膜上或静脉内的管理的早药品效果 .Methods28 由于在 2014 年 11 月和 2016 年 1 月之间的大腰部的圆盘形成疝经历了 PELD 的连续病人被跟随在上面为 6 个月。这些病人根据他们在 PELD 以后接受了的治疗被划分成二个组。14 个病人(组 A ) 被 PELD 和硬膜上的类固醇对待,当另外的 14 个病人(组 B ) 被 PELD 和静脉内的类固醇对待时。我们由外科手术前、手术后的视觉类似物规模(管) 评估了有效性为背和腿疼痛的分数,和在在经由临床的图表和电话的外科以后的 3 个星期的手术后的 Oswestry 残疾索引(ODI ) 会见。因为 well.ResultsThere 是在管的重要减少,工作的手术后的医院停留和时间回来被调查(回来,腿) , ODI,和时间回来工作(p < 0.05 ) 。为管(背) ,组 A 在外科以后在 1 天和 1 个星期与组 B 相比显示出重要减少(p = 0.011, p = 0.017 ) 。至于管(腿) ,组 A 在 1 天, 1 个星期, 3 个星期,和 3 月后续考试与组 B 相比显示出重要减少(p = 0.002, p = 0.006, p < 0.001, p < 0.001 ) 。为 ODI,组 A 与组 B 相比显示出著名减少(p < 0.001 ) 。在二个组的手术后的医院停留不是统计上不同的(p = 0.636 ) 。但是在组 A 工作的时间回来在组 B 是比那显著地短的(p = 0.023 ).ConclusionPatients 为大腰部的圆盘形成疝与硬膜上的类固醇管理经历了 PELD 的人,与与静脉内的类固醇管理经历了 PELD 的那些相比显示出有利药品效果。
Purpose: It has been suggested that patients with traumatic insults are resuscitated into a state of an early systemic inflammatory response. We aimed to evaluate the influence of hemorrhagic shock and resuscitation (HSR) upon the inflammatory response capacity assessed by overall TNF-α secretion capacity of the host compared to its release from circulating leukocytes in peripheral circulation. Methods: Rats (8/group) subjected to HS (MAP of 30e35 mmHg for 90 min followed by resuscitation over 50 min) were challenged with Lipopolysaccharide (LPS), 1 mg/kg intravenously at the end of resuscitation (HSR-LPS group) or 24 h later (HSR-LPS24 group). Control animals were injected with LPS without bleeding (LPS group). Plasma TNF-α was measured at 90 min after the LPS challenge. In addition, whole blood (WB) was obtained either from healthy controls (CON) immediately after resuscitation (HSR), or at 24 h post-shock (HSR 24). WB was incubated with LPS (100 ng/mL) for 2 h at 37 C. TNF-α concentration and LPS binding capacity (LBC) was determined. Results: Compared to LPS group, HSR followed by LPS challenge resulted in suppression of plasma TNF-a in HSR-LPS and HSR-LPS24 groups (1835 ± 478, 273 ± 77, 498 ± 200 pg/mL, respectively). Compared to CON the LPS-induced TNF-a release capacity of circulating leukocytes ex vivo was strongly declined both at the end of resuscitation (HSR) and 24 h later (HSR24) (1012 ± 259, 313 ± 154, 177 ± 63 ng TNF/mL, respectively). The LBC in WB was similar between CON and HSR and only moderately enhanced in HSR24 (57 ± 6, 56 ± 6, 71 ± 5 %, respectively). Conclusion: Our data suggest that the overall inflammatory response capacity is decreased immediately after HSR, persisting up to 24 h, and is independent of LBC.