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大剂量甲基强的松龙在脊髓型颈椎病围手术期应用的探讨
引用本文:潘胜发,孙宇,张凤山,张立.大剂量甲基强的松龙在脊髓型颈椎病围手术期应用的探讨[J].中国脊柱脊髓杂志,2005,15(12):713-715.
作者姓名:潘胜发  孙宇  张凤山  张立
作者单位:北京大学第三医院骨科,100083,北京市
摘    要:目的:探讨大剂量甲基强的松龙(MP)在脊髓型颈椎病患者围手术期应用的价值。方法:脊髓型颈椎病患者125例,分为3组,A组:术后未用激素治疗组,42例;B组:氟美松治疗组,38例;C组:大剂量MP+抗酸药组,45例。比较三组患者手术前后的神经功能评分(JOA 17分法),统计并发症,观察患者术后咽部不适的时间。结果:3组患者术前、术后1周及术后3个月的JOA评分比较无显著性差异;C组患者术后无症状反跳现象,术后咽部不适的时间明显短于A、B两组(P〈0.001);A组发生l例伤口感染,B组出现1例消化道隐性失血,C组出现1例毛囊炎、2例消化道隐性失血。结论:大剂量甲基强的松龙可以改善脊髓型颈椎病患者术后咽部不适的症状,应用安全,但对神经功能恢复无明显作用。

关 键 词:甲基强的松龙  脊髓型颈椎病  手术
文章编号:1004-406X(2005)-12-0713-03
收稿时间:2005-10-13
修稿时间:2005年10月13

The effects of postoperative high dose mythylprednisolone on the patients undergoing cervical spine surgery
PAN Shengf,SUN Yu,ZHANG Fengshan,et al.The effects of postoperative high dose mythylprednisolone on the patients undergoing cervical spine surgery[J].Chinese Journal of Spine and Spinal Cord,2005,15(12):713-715.
Authors:PAN Shengf  SUN Yu  ZHANG Fengshan  
Institution:Department of Orthopaedics,the Third Hospital of Peking University,Beijing, l00083,China
Abstract:Objective:To investigate the effects of postoperative high dose mythylprednisolone (MP) on the patients of cervical spondylotic myelopathy (CSM) undergoing cervical spine surgery.Method:125 cases of CSM undergoing cervical spine surgery were divided to three groups,group A (control):42 cases,group B(dexamethasone sodium phosphate):38 cases,group C (high dose methylprednisolone+ranitidine):45 cases.Comparison of neurological function by JOA was observed.Postoperative pharyngolaryngeal lesions and other complications were also analyzed.Result:Statistical analysis showed that postoperative high dose MP did not influence the outcome of CSM patients undergoing cervical spinal surgery (P>0.05),but can reduce extent of postoperative reperfusion lesions and pharyngolaryngeal lesions (P<0.01).Complications such as gastrointestinal bleeding and wound infections were not observed.Conclusion:High dose MP used postoperatively on CSM patients can reduce extent of postoperative reperfusion lesions and pharyngolaryngeal lesions.The usage of MP mentioned above is safe.
Keywords:Methylprednisolone  Cervical spondylotic myelopathy  Operation
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