CAJ | 학술논문

目的：评价甲基强的松龙冲击疗法治疗急性脊髓损伤（ ASCI）的临床疗效及不良反应。方法回顾性分析ASCI患者60例，分为对照组（ n＝32）和试验组（ n＝28）。对照组仅予以止血、脱水、神经营养等支持治疗，试验组在对照组的基础上，于伤后8 h内给予甲基强的松龙30 mg? kg－1? h－1，静脉滴注（＜15 min），间隔45 min后给予甲基强的松龙5．4 mg? kg－1? h－1，静脉滴注维持24 h。所有患者分别于入院时和治疗6周后按美国脊髓损伤学会评分标准（ ASIA）评定神经功能恢复情况和不良反应。结果治疗后，2组患者躯体感觉及躯体运动功能评分较治疗前均显著提高（ P＜0．05 ），且试验组治疗后躯体感觉及运动评分均高于对照组（P＜0．05）。但试验组胃肠道反应发生率显著高于对照组（P＜0．05）。结论甲基强的松龙冲击疗法可有效缓解脊髓压迫，减轻神经元继发性损伤，改善脊髓神经功能，但不良反应发生率较高。
목적：평개갑기강적송룡충격요법치료급성척수손상（ ASCI）적림상료효급불량반응。방법회고성분석ASCI환자60례，분위대조조（ n＝32）화시험조（ n＝28）。대조조부여이지혈、탈수、신경영양등지지치료，시험조재대조조적기출상，우상후8 h내급여갑기강적송룡30 mg? kg－1? h－1，정맥적주（＜15 min），간격45 min후급여갑기강적송룡5．4 mg? kg－1? h－1，정맥적주유지24 h。소유환자분별우입원시화치료6주후안미국척수손상학회평분표준（ ASIA）평정신경공능회복정황화불량반응。결과치료후，2조환자구체감각급구체운동공능평분교치료전균현저제고（ P＜0．05 ），차시험조치료후구체감각급운동평분균고우대조조（P＜0．05）。단시험조위장도반응발생솔현저고우대조조（P＜0．05）。결론갑기강적송룡충격요법가유효완해척수압박，감경신경원계발성손상，개선척수신경공능，단불량반응발생솔교고。
Objective To assess the efficacy and adverse reaction of methyl prednisolone for the treatment of patients with acute spinal cord injury ( ASCI ) .Methods Sixty cases with ASCI were retrospectively reviewed and analyzed in our hospital from 2010 to 2014.Thirty-two sub-jects in control group only received hemostasis, dehydration, and nerve nutrition and so on, based on which the twenty-eight subjects in treat-ment group received high dose of methyl prednisolone 30 mg? kg-1? h-1 through intravenous infusion less than 15 minutes and 45 minutes later, 5.4 mg? kg-1? h-1 methyl prednisolone was infused in 24 hours.The clinical efficacy and adverse reactions were evaluated by American Spinal Injury Association ( ASIA) score before treatment and six weeks after treat-ment.Results The somatosensory and somatomotion scores were all improved after treatment in two groups(P<0.05), and both scores in the treatment group were much higher than those in the control group after treatment ( P<0.05).But the gastrointestinal reactions found in the treat-ment group were much more than those in the control group ( P<0.05). Conclusion Methyl prednisolone shock therapy can relieve spinal cord compression and reduce secondary neuronal damages, thereby it can improve the function of the spinal nerves, but with higher incidence of complications.