依达拉奉在脊髓型颈椎病围手术期应用的效果观察

目的:探讨自由基清除剂依达拉奉在脊髓型颈椎病围手术期应用的价值。方法:前路减压、植骨内固定治疗58例脊髓型颈椎病,治疗组30例患者围手术期应用依达拉奉,术前30min静脉滴注(30mg),术后连续使用6d(30mg/次,2次/d);对照组28例,未应用依达拉奉。采用电子自旋共振(electronspinresonance,ESR)检测患者术前30min、减压后30min脑脊液自由基含量;术前及术后1d、1周、3个月采用JOA评分评定神经功能,观察术后症状反跳发生率。结果:脑脊液自由基含量术前两组无明显差异(P>0.05),减压后30min治疗组较对照组明显减少(P<0.05)。术前、术后1d、术后3个月治疗组与对照组JOA评分无明显差异(P>0.05),术后1周治疗组JOA评分优于对照组(P<0.05)。治疗组术后症状反跳的发生率、持续时间均低于对照组(P<0.05)。结论:脊髓型颈椎病患者围手术期应用自由基清除剂依达拉奉,能降低脑脊液自由基浓度,减少术后症状反跳,提高术后短期疗效。

Effect of free radical scavenger on anterior decompression for cervical spondylotic myelopathy

Objective:To observe the therapeutic effect of free radical scavenger(edaravone) on anterior decompression for cervical spondylotic myelopathy.Method:Anterior decompression for cervical spondylotic myelopathy in 58 cases were assigned into two groups.Edaravone group,30 cases,with free radical scavenger therapy;control group,28 cases,without free radical scavenger therapy.Patients received scores based on the Japanese Orthopaedic Association(JOA) functional scales preoperatively and postoperatively.Concentration of free radical in cerebrospinal fluid was monitored by electron spin resonance(ESR).Result:Concentration of free radical in cerebrospinal fluid was not significantly different between two groups before operation(P>0.05),but the concentration in edaravone group was significantly decreased in comparison with that of control group 30min after decompression(P<0.05).There were no differences in JOA scores between two groups before operation,1 days and 3 months after operation(P>0.05).The JOA score was better in edaravone group 7 days after operation(P<0.05).Less patients with relapse in edaravone group(P<0.05).Conclusion:Free radical scavenger edaravone can inhabit free radical formation in spinal cord tissue and reduce postoperative relapse and improve short term prognosis in cervical spondylotic myelopathy.