CAJ | 학술논문

目的探讨鼠神经生长因子(mNGF)在合并足下垂的腰椎间盘突出症患者中的应用价值. 方法对复旦大学附属中山医院骨科自2008年1月至2011年6月进行手术治疗的76例合并足下垂的腰椎间盘突出症患者的临床资料进行回顾性分析,其按照术后处理方法不同分为2组:联合组36例(应用mNGF联合甲钴胺治疗)、单纯组40例(单纯应用甲钴胺治疗).分析患者治疗后一般情况,比较2组治疗后1周、4周、12周、12个月时视觉模拟评分(VAS)和神经功能(感觉功能和肌力)恢复情况. 结果患者获得12～54个月(平均24.8个月)随访,无一例死亡,均无创口感染,平均8个月时植骨融合.治疗后1周、4周、12周及12个月时2组VAS评分均明显低于治疗前,且各时间点联合组VAS评分亦明显低于单纯组,差异有统计学意义(P＜0.05).治疗后1周、4周、12周及12个月时联合组感觉功能改善有效率均明显优于单纯组,差异有统计学意义(P＜0.05)；除1周外其余时间点联合组肌力改善有效率均明显优于单纯组,差异有统计学意义(P＜0.05). 结论 mNGF与甲钴胺联合使用能促进合并足下垂的腰椎间盘突出症患者的神经功能恢复.
목적 탐토서신경생장인자(mNGF)재합병족하수적요추간반돌출증환자중적응용개치. 방법 대복단대학부속중산의원골과자2008년1월지2011년6월진행수술치료적76례합병족하수적요추간반돌출증환자적림상자료진행회고성분석,기안조술후처리방법불동분위2조:연합조36례(응용mNGF연합갑고알치료)、단순조40례(단순응용갑고알치료).분석환자치료후일반정황,비교2조치료후1주、4주、12주、12개월시시각모의평분(VAS)화신경공능(감각공능화기력)회복정황. 결과 환자획득12～54개월(평균24.8개월)수방,무일례사망,균무창구감염,평균8개월시식골융합.치료후1주、4주、12주급12개월시2조VAS평분균명현저우치료전,차각시간점연합조VAS평분역명현저우단순조,차이유통계학의의(P＜0.05).치료후1주、4주、12주급12개월시연합조감각공능개선유효솔균명현우우단순조,차이유통계학의의(P＜0.05)；제1주외기여시간점연합조기력개선유효솔균명현우우단순조,차이유통계학의의(P＜0.05). 결론 mNGF여갑고알연합사용능촉진합병족하수적요추간반돌출증환자적신경공능회복.
Objective To investigate the effect of mouse nerve growth factor (mNGF) on treatment of patients with lumbar disc hemiation combined with foot drop.Methods The clinical data of 76 patients suffering from lumbar disc herniation combined with foot drop,admitted to our hospital from January 2008 and June 2011,were retrospectively analyzed.The patients were divided into two groups according to the postoperative treatments; in particular,one group of 36 patients was treated with a combination of mNGF and methylcobalamin (Group C),whereas the other group of 40 patients was treated with methylcobalamin alone (Group A).The visual analogue scale (VAS) scores and the recovery of neurological function among these patients at 1,4 and 12 weeks,and 12 months after surgery were recorded and compared.Results The follow-up duration ranged from 12 to 54 months (mean 24.8 months).For both groups,patients'VAS scores at observation each time point were lower than their VAS scores prior to treatment (P＜0.05); moreover,the VAS scores of Group C were significantly lower than Group A at every time point (P＜0.05).Higher effective rates of sensory improvement were observed in Group C than those in in Group A and exhibited statistically significant differences at each time point (P＜0.05).The effective rate of muscular strength improvement of the two groups didn't differ significantly at 1 week after surgery (P＞0.05) but exhibited statistically significant differences at subsequent time points (P＜ 0.05).Conclusion Application of mNGF in combination with methylcobalamin promotes the recovery of neurological function in patients suffering from lumbar disc herniation with foot drop.