不同剂量甲泼尼龙治疗脊髓型颈椎病术后创伤反应的临床研究

The clinical research of methylprednisolone on postoperative traumatic reaction of cervical spondylotic myelopathy

目的 探讨不同剂量甲泼尼龙治疗脊髓型颈椎病前路减压术后创伤反应的应用价值。方法 选取本院骨科前路手术减压的脊髓型颈椎病 75例 ,根据用药和剂量不同分为 4组 ,即地塞米松组 (10mg) ,甲泼尼龙小剂量组 (80mg)、中剂量组(6 0 0mg)、大剂量组 (10 0 0mg)。分别观察各组临床症状、体征和不良反应。结果 甲泼尼龙大剂量组的疗效优于地塞米松组和甲泼尼龙小剂量组 (P <0 .0 1) ,不良反应并未明显增加 (P >0 .0 5 )。结论 甲泼尼龙可以减轻脊髓型颈椎病前路减压术后创伤反应。适当的大剂量 (10 0 0mg)可以在不增加不良反应的同时 。

Aim To discuss the therapeutic effects of methylprednisolone on postoperative traumatic reaction of anterior decompressive operation of cervical spondylotic myelopathy.Methods The clinical data of 75 cases of cervical spondylotic myelopathy,which were performed anterior decompressive operation in our department during March 2000 to March 2002,are analyzed. According to the different drugs and their dose,patients are divided into four groups,namely,dexamethasone group(10mg),low-dose of methylprednisolone group (80mg),medium-dose of methylprednisolone group (160mg),high-dose of methylprednisolone group (1 000mg).The symptoms,the signs and the side-effects are observed respectively.Results The therapeutic effects of the high-dose of methylprednisolone group are better than those of the dexamethasone group and low-dose of methylprednisolone group(P<0.01),and its side-effects are no more than the other groups(P>0.05).Conclusion Methylprednisolone may reduce postoperative traumatic reaction of anterior decompressive operation of cervical spondylotic myelopathy.Appropriate high-dose of methylprednisolone (1 000mg) may achieve the effects we need clinically,meanwhile the side-effects don't increase.