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鼠神经生长因子联合甲泼尼龙治疗外伤性马尾神经损伤临床疗效及安全性研究

发布日期:2016-09-02 点击次数:1414 字体显示:【大】  【中】  【小】

鼠神经生长因子联合甲泼尼龙治疗外伤性马尾神经损伤临床疗效及安全性研究

【作者】 李勇

【Author】LI Yong

【作者单位】 信阳市中心医院 康复医学科,河南 信阳 464000

 

【摘要】  目的 评价鼠神经生长因子联合甲泼尼龙治疗外伤性马尾神经损伤的临床疗效及安全性方法 54 例外伤性马尾神经损伤患者按照体重随机分为对照组及试验组,各 27 所有患者均给予椎管减压内固定术以及抗炎止血脱水等常规治疗在常规治疗基础上,对照组给予静脉滴注甲泼尼龙30 mg·kg-115min 内静脉注射) ,然后以 5.4mg·kg·h)-1连续静滴 23 h; 在对照组的基上,试验组加用鼠神经生长因子 30 μg,每日 次肌内注射,共治疗 比较 组患者治疗前后的神经功能评分治疗有效率及安全性结果 治疗后,组患者的功能独 立 性 评 定 量 表 ( FIM) 评分 ,对 照 组 与 试 验 组 分 别 为 ( 62.32 ± 7.84) ,79.47 ±11.34) 分; 日常生活活动能力( ADL) 量表评分,对照组与试验组分别为50.77 ±7.21) ,( 73.23 ±10.09) 分,组间比较差异有统计学意义( 均 P <0. 05) ; 试验组的治疗有效率为 81.48% 22/27 例) 与对照组为 62. 96% 17/27 例) ,组间比较差异有统计学意义( P < 0. 05) ; 组患者的药物不良反应以消化道和泌尿道为主,试验组与对照组的药物不良反应发生率分别为 18.52% 22. 22% 组比较差异无统计学意义( P >0. 05结论 鼠神经生长因子联合甲泼尼龙能够显著改善外伤性马尾神经损伤患者的神经功能,且安全性较高。

【Abstract】Objective To evaluate the clinical efficacy and safety of mouse nerve growth factor combined with methylprednisolone in the treat-ment of traumatic injury of cauda equina. Methods Fifty - four cases of patients with traumatic injury of cauda equina were randomly divided into the control group and treatment group27 cases in each group. All patients were given spinal decompressioninternal fixation and other conventional treatments such as anti inflammationhemostasis anddehydration. On the basis of routine treatmentthe control group was given intravenous infusion of methylprednisolone 30 mg·kg-1+ 5.4 mg·kg·h)-1continuous static drop 23 h. On the basis of the control groupthe treatment group was added with intramuscular injection of mouse nerve growth factor 30 μgonce dailytotal treatment for 8 weeks. Before and after treatmentthe neurological function scoretreatment efficacy and safety of the two groups were compared. Results After treatmentthe Functional Independence Measure FIMscore were 62. 32 ± 7. 84 ) ,79. 47 ± 11. 34in control group and treatment grouprespectivelyand the Activities of Daily Living ADL ) score were 50. 77 ± 7. 21 ) ,( 73. 23 ± 10. 09 in control group and treatment grouprespectively. The above items of treatment group were higher than those in control groupP < 0. 05. The treatment efficiency of the treatment group was 81. 48% 22 /27) ,significantly higher than that of control group which was 62. 96% 17 /27) ( P < 0. 05. The adverse drug reactions ADRsin two groups were mainly in the digestive tract and urinary tract. Total ADRs rate in treatment group and control group were 18. 52% 5 /27 ) ,22. 22% 6 /27 ) ,respectively. There was not statistically different between the two groupsP > 0. 05. Conclusion The mouse nerve growth factor combined with methylprednisolone can significantly improve the neurological function in patients with traumatic injury of cauda equinawith a high safety.

【关键词】 鼠神经生长因子; 甲泼尼龙; 外伤性马尾神经损伤

【Keywords】mouse nerve growth factormethylprednisolonetraumatic injury of cauda equin

DOI: 10. 13699 / j. cnki. 1001-6821. 2016. 15. 011