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大剂量甲泼尼龙冲击治疗急性脊髓炎的临床观察
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| 篇名： | 大剂量甲泼尼龙冲击治疗急性脊髓炎的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨大剂量甲泼尼龙冲击治疗急性脊髓炎的疗效及其对患者神经功能恢复、锥体束传导功能和感觉障碍的影响。方法： 116例急性脊髓炎患者随机分为观察组和对照组，每组58 例。两组患者均给予常规治疗，在此基础上对照组患者给予地塞米松磷酸钠注射液0.4 mg/（kg·d），静脉滴注，每天1次，7 d后改服醋酸泼尼松片 60 mg，每天1次并逐渐减量至5 mg/d。观察组患者给予注射用甲泼尼龙琥珀酸钠1 000 mg，静脉滴注，每天1次，7 d后改服醋酸泼尼松片60 mg，每天1次并逐渐减量至5 mg/d。两组疗程均为1个月。比较两组患者神经功能恢复时间、锥体束传导功能、感觉障碍评分、临床疗效和不良反应发生情况。结果：治疗后观察组患者总有效率显著高于对照组（93.10％ vs. 79.31％），肌力改善≥2 级时间、下地行走时间、排尿排便功能恢复时间均显著短于对照组，差异均有统计学意义（P＜0.05）。治疗前，两组患者上、下肢锥体束传导潜伏期、波幅和感觉、痛觉、触觉损伤评分比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者上、下肢锥体束传导潜伏期显著低于同组治疗前，且观察组显著低于对照组；两组患者锥体束传导波幅和感觉、痛觉、触觉损伤评分显著高于同组治疗前，且观察组显著高于对照组，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规治疗基础上，大剂量甲泼尼龙冲击治疗急性脊髓炎疗效较好，有助于改善患者锥体束传导功能，缓解感觉障碍程度，促进神经功能恢复，安全性亦较好。 |
| ABSTRACT： | OBJECTIVE： To investigate therapy efficacy of large-dose of methylprednisolone plus therapy for acute myelitis，and it effects on nerve function recovery，pyramidal tract conduction function and sensory disturbance. METHODS： A total of 116 patients with acute myelitis were randomly divided into observation group and control group， with 58 cases in each group. Both group received conventional treatment. Control group was additionally given Dexamethasone sodium phosphate injection 0.4 mg/（kg·d） intravenously， once a day； 7 d later， they were given Methylprednisolone tablet 60 mg， orally，qd，gradually decreasing to 5 mg/d. Observation group was given Methylprednisolone sodium succinate injection 1 000 mg intravenously， once a day； 7 d later，they were given Methylprednisolone tablet 60 mg， orally，qd， gradually decreasing to 5 mg/d. The treatment course in eaeh group was 1 month. The nerve function recovery time， pyramidal tract conduction function， sensory disturbance scores， clinical efficacy and ADR were compared between 2 groups. RESULTS： After treatment， the response rate of observation group was significantly higher than that of control group （93.10％ vs. 79.31％）； the time of muscle strength improvement≥grade 2， walking down the ground， urination and defecation function recovery in observation group were all significantly shorter than control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in lower limb cone conduction latency， amplitude of pyramidal tract conduction， scores of sensation， sense of pain and touch between 2 groups. After treatment， lower limb cone conduction latency of 2 groups were significantly lower than before， and the observation group was significantly lower than the control group， the amplitude of pyramidal tract conduction， scores of sensation， sense of pain and touch in 2 groups were significantly higher than before， and the observation group was significantly higher than the control group， with statistical significance （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Based on conventional treatment，large-dose of methylprednisolone plus therapy shows good efficacy in the treatment of acute myelitis，which can helps to improve pyramidal tract conduction function of patients with acute myelitis， ease sensory disturbance， promote the nerve functional recovery with good safety. |
| 期刊： | 2017年第28卷第21期 |
| 作者： | 王昕雯，田向阳 |
| AUTHORS： | WANG Xinwen，TIAN Xiangyang |
| 关键字： | 甲泼尼龙；急性脊髓炎；锥体束传导功能；感觉障碍 |
| KEYWORDS： | Methylprednisolone； Acute myelitis； Pyramidal tract conduction function； Sensory disturbance |
| 阅读数： | 1075 次 |
| 本月下载数： | 13 次 |
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