| 王迎光,徐卫国,李文凯.甘露醇联合甲泼尼龙对颈椎单开门椎管扩大成形术后脊髓神经功能恢复的影响.骨科,2021,12(2): 128-131,136. |
| 甘露醇联合甲泼尼龙对颈椎单开门椎管扩大成形术后脊髓神经功能恢复的影响 |
| Effect of mannitol and methylprednisolone on neurological function recovery following posterior cervical single open-door laminoplasty |
| 投稿时间：2020-12-07 |
| DOI：10.3969/j.issn.1674-8573.2021.02.006 |
| 中文关键词: 颈椎 后路减压手术 椎板成形术 甲泼尼龙 甘露醇 |
| 英文关键词: Cervical vertebrae Posterior decompression Laminoplasty Methylprednisolone Mannitol |
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| 中文摘要: |
| 目的 探讨甘露醇联合甲泼尼龙对颈椎单开门椎管扩大成形术后脊髓神经功能恢复的影响。方法 回顾性分析2017年1月至2018年12月在我院行颈椎单开门椎管扩大成形手术的44例病例，根据围手术期是否使用甲泼尼龙和甘露醇分为观察组（21例）和对照组（23例）。比较两组术前及术后3 d、2周、3个月、1年的颈部疼痛视觉模拟量表（visual analogue acale，VAS）评分、日本骨科协会（Japanese Orthopaedic Association，JOA）评分改善率、颈椎功能障碍指数（neck disability index，NDI），以及术后2周内的并发症发生率。结果 观察组术后3 d的VAS评分及NDI均明显低于对照组（P均＜0.05），JOA评分改善率明显高于对照组（P＜0.05）；但观察组与对照组术后2周、3个月、1年的VAS评分、JOA评分改善率、NDI比较，差异均无统计学意义（P均＞0.05）。观察组术后并发症发生率明显高于对照组（23.8% vs. 0），差异有统计学意义（P＜0.05）。结论 甘露醇联合甲泼尼龙可促进颈椎单开门椎管扩大成形术后早期脊髓神经功能恢复，但是会增加术后并发症的发生率，临床使用应该权衡利弊。 |
| 英文摘要: |
| Objective To determine the effect of mannitol and methylprednisolone on neurological function recovery following posterior cervical single open-door laminoplasty. Methods A retrospective study was conducted on 44 patients undergoing posterior cervical single open-door laminoplasty in our hospital from January 2017 to December 2018. Twenty-one patients who received mannitol and methylprednisolone during perioperative period (observation group) were compared with a matched cohort of controls (23 cases) who did not receive mannitol or methylprednisolone. Visual analog scale (VAS), Japanese Orthopedic Association (JOA) scores, neck disability index (NDI) were compared between two groups pre-operatively, 3 days, 2 weeks, 3 months and 1 year postoperatively. The incidence of complications was also measured within 2 weeks after operation. Results VAS scores, improvement rate of JOA scores, and NDI were significantly improved in observation group as compared with control group at 3rd day after operation (P＜0.05), but there was no significant difference between two groups at 2nd week, 3rd month and 1st year postoperatively (P＞0.05). The incidence of postoperative complications in observation group was significantly higher than in control group (23.8% vs. 0, P＜0.05). Conclusion The perioperative use of mannitol and methylprednisolone in posterior cervical single open-door laminoplasty can promote the neurological function recovery in the early stage after operation, while it may result in the increase rate of postoperative complications. Therefore, for clinical application, there is a trade-off between the benefits and side effects. |
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