甲基强的松龙在脊髓型颈椎病围手术期应用的价值

目的:探讨甲基强的松龙(MP)在脊髓型颈椎病(CSM)围手术期应用的价值。方法:2004年1月～2005年1月对18例CSM患者行颈椎前路减压手术,并于围手术期应用MP(治疗组);对照组25例CSM患者仅行前路减压手术。观察两组患者术后一般情况、并发症,并检测术前和术后第1、3、7天的血清白细胞介素-6(IL-6)和C反应蛋白(CRP);采用Odom′s评分标准评估患者术后6个月时神经功能恢复情况。结果:术后3d内MP治疗组患者体温、基础代谢率增幅明显低于对照组(P<0.05),血清IL-6和CRP与对照组比较也显著降低(P<0.05);术后第7天血清IL-6和CRP两组之间无显著性差异(P>0.05);两组患者并发症情况无显著性差异(P>0.05);术后6个月两组患者神经功能均明显恢复,对照组和MP治疗组优良率分别为76.0%、83.3%,两组之间有显著性差异(P<0.05)。结论:围手术期应用MP能缓解手术应激反应,促进神经功能恢复,进而改善CSM患者的手术疗效。

Clinical significance of perioperative methylprednisolone on cervical spondylotic myelopathy

Objective:To explore the significance of perioperative methylprednisolone(MP) on the prognosis of patients with cervical spondylotic myelopathy(CSM).Method:25 patients with CSM in the control group underwent anterior decompression only,18 patients with CSM in the experiment group obtained additional MP perioperatively.The general status and complications were compared in the two groups,as well as the concentration of IL-6 and CRP in the serum were analyzed.Moreover postoperative neurological recover was evaluated at 6 months following the operation.Result:Concentration of IL-6 and CRP in the serum were decreased in the MP group(P<0.05),which showed lower temperature and BMR within the first three days after the operation(P<0.05).No statistical difference of the concentration of IL-6 and CRP in the serum were noted between the two groups at the 7th day after the operation(P>0.05).There was no significant difference of the complications in the two groups(P>0.05).Patients in the MP group showed better neurological recovery at follow-up for 6 months,the excellent and good rate of MP group was 83.3%,the control group was 76.0%(P<0.05).Conclusion:Perioperative MP can alleviate the surgical stress and promote the neurological recovery,and thus ameliorate the prognosis of patients with CSM.