甲泼尼龙联合注射用鼠神经生长因子治疗急性脊髓损伤的临床应用及护理

目的研究和观察急性脊髓损伤（ASCI）患者应用甲泼尼龙联合注射用鼠神经生长因子（鼠NGF）的治疗方案的价值及护理。方法选取急性脊髓损伤患者共53例，分为治疗组33例和对照组20例，治疗组术后采用甲泼尼龙联合注射用鼠NGF的治疗方案，对照组为未采用此方案的常规治疗方法。对2组患者均实施整体护理方案，按日本骨科协会（JOA）评分计算患者术前、术后1周、术后1年的神经功能恢复率，并统计并发症发生情况，远期神经功能评分增加按ODOM分级评分。结果2组患者组间术前JOA评分无统计学差异（P〉O．05）；2组1年后随访未发现并发症，植骨融合良好，内固定稳定；治疗组术后5d发生感染1例，经抗炎抗生素治疗后治愈。与术前相比，2组术后1周及1年JOA评分均显著增加，治疗组改善率显著高于对照组，差异有统计学意义（P〈0．01）；1年后治疗组ODOM评分优良率显著高于对照组，差异有统计学意义（P〈0．01）。结论甲泼尼龙联合注射用鼠NGF治疗急性脊髓损伤的同时配合以优质的护理，可改善急性脊髓损伤患者术后的疼痛，促进神经功能的恢复，对于改善患者生活质量具有显著意义。

Clinical application of methylprednisolone combined with injectable mouse nerve growth factor in treatment of acute spinal cord injury and related nursing measures

Objective To explore and observe the clinical value of methylprednisolone com- bined with injectable mouse nerve growth factor （mNGF） in the treatment of patients with acute spinal cord injury （ASCI） and summarize related nursing measures. Methods 53 ASCI patients were collected and divided into treatment group （n = 33） and the control group （n = 20）. The treatment group was conducted with therapeutic scheme of methylprednisolone combined with in- jectable mNGF after operation, while the control group was conducted with conventional therapeu- tic scheme. Both groups was conducted with holistic nursing plan. According to the standard of Japanese Department of Orthopedics As~ciation （JOA）, the recovery rate of nerve function was assessed at the time points of before operation, one week after operation and one year after opera- tion, and the condition of complications was recorded as well. Long- term neurological function score was assessed based on ODOM classification. Results There was no significant difference of preoperative JOA score between two groups（ P 〉0.05） ; during the follow - up in one year after operation, no complications were observed in both groups, and all the patients had good bone fusion and internal fixation; 5 days after operation, one patient had infection in the treatment group, who was cured with positive anti - inflammatory therapy. Compared with the JOA score before opera- tion, the JOA scores in one weeks and one year after operation increased in both groups, and the improved rate in the treatment group was significantly higher than that in the control group, there were significant differences between two groups （ P 〈 0 . 0 1 ） ; one year later , the excellent and good rates of ODOM score in the treatment groupwere higher than those in the control group （P 〈 0.01 ）. Conclusion For the treatment of ASCI, combination therapy of methylpred- nisolone and injectable mNGF as well as qualified nursing can alleviate the postoperative sufferings of ASCI patients, promote the recovery of nerve function and improve the quality of life of pa- tients.