大剂量甲基强地松龙治疗颈椎无骨折脱位脊髓损伤的临床研究

作者对应用大剂量甲基强地松龙、外科减压及两者联合使用对颈椎无骨折脱位脊髓损伤患者的治疗效果进行了比较研究。将３２例颈椎无骨折脱位脊髓损伤患者分为三组：甲基强地松龙（ＭＰ）组８例,在伤后８小时内给予大剂量甲基强地松龙;外科减压组１２例,在伤后４８小时内给予手术减压;ＭＰ＋外科减压组１２例,在伤后８小时内给予大剂量甲基强地松龙及伤后４８小时内行手术减压。根据脊髓损伤的神经和功能评分标准,评定脊髓损伤程度和疗效。随访１年,结果显示ＭＰ＋外科减压对感觉及运动的恢复,不论对完全性脊髓损伤者,还是不完全性脊髓损伤者均明显优于单纯大剂量甲基强地松龙或外科减压组,而三组之间并发症发生率无明显差异。

High-methylprednisolone treatment in acute cervical spinal cord injury without fracture and dislocation

We compared methylprednisolone (MP), surgical decompression and both in acute cervical spinal cord injury without fracture and dislocation. The study involved 32 acute cervical spinal cord injury without fracture and dislocation. MP was given to 8 cases (high-MP group) within 8 hours after injury. 12 cases (surgical group) underwent surgical decompression (anterior or posterior approach) within 48 hours after injury. 12 cases (combined group) were treated with MP within 8 hour of their injury and surgical decompression within 48 hours after injury. Neurological function was assessed using scores according to international standards for neurological and functional classification of spinal cord injury. The results showed that combined group were more effective than high-MP or surgical group, in the complete or incomplete spinal cord injury, and in motor and sensory. The risk of such complication as gastrointestinal bleeding or delayed wound healing is not significant with using high-MP.