大剂量甲泼尼龙冲击治疗急性脊髓炎的临床观察

发布时间：2018-06-27 23:29

  本文选题：甲泼尼龙 + 急性脊髓炎　； 参考：《中国药房》2017年21期

【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(P0.05)。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(P0.05)。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(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。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 the effect of high dose methylprednisolone on the recovery of nerve function, pyramidal bundle conduction function and sensory disturbance in patients with acute myelitis. Methods 116 patients with acute myelitis were randomly divided into observation group and control group with 58 cases in each group. The patients in both groups were given routine treatment. The control group was given dexamethasone sodium phosphate injection 0.4 mg/ (kg d), intravenous drip once a day for 7 days before taking prednisone acetate tablets 60 mg once a day and gradually reduced to 5 mg / d. The patients in the observation group were given 1 000 mg of methylprednisolone sodium succinate for injection, intravenous drip, once a day for 7 days, then changed to 60 mg of prednisone acetate tablets, once a day and gradually reduced to 5 mg / d. The course of treatment was 1 month in both groups. Nerve function recovery time, pyramidal bundle conduction function, sensory dysfunction score, clinical efficacy and adverse reactions were compared between the two groups. Results: the total effective rate of the observation group was significantly higher than that of the control group (93.10vs.79.31%), the improvement of muscle strength 鈮，

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