倍他米松与医用生物蛋白胶在腰椎神经根减压术中的联合应用评价

发布时间：2018-06-10 09:55

本文选题：倍他米松 + 医用生物蛋白胶　；参考：《中国医院药学杂志》2017年08期

【摘要】：目的:评价在神经根减压术中联合应用倍他米松和医用生物蛋白胶的疗效。方法:观察对象为腰椎神经根减压术术后的120例患者,根据术后处理方式的不同将患者分为4组:A组单纯手术组,B组单纯应用倍他米松组,C组单纯应用医用生物蛋白胶组,D组倍他米松联合应用医用生物蛋白胶组。观察各组术后直腿抬高试验角度、改良JOA评分、ODI评分、VAS评分、术后48 h内引流量,分析各组检查结果的差异。结果:术前患者年龄、病史时程、男女比例、直腿抬高试验角度、改良JOA评分、ODI评分、VAS评分、术后48 h内引流量均无统计学意义。术后各组患者直腿抬高试验角度在不同时期均有明显改善,差异有统计学意义(P0.05)。术后4周,D组患者髋关节运动角度显著高于其他3组,差异有统计学意义[(75±23)°vs.(54±19)°,vs.(62±20)°,vs.(64±21)°,(P0.05)];术后4周,D组患者膝关节运动角度显著低于其他3组,差异有统计学意义[(11±4)°vs.(16±6)°,vs.(13±5)°,vs.(14±5)°,(P0.05)];术后4周,D组患者髋关节运动角度显著高于A组,差异有统计学意义[(74±21)°vs.(54±19)°,(P0.05)]。术后患者症状也有显著改善:术后4周,D组患者改良JOA评分显著高于其他3组,差异有统计学意义[(22±7)vs.(16±6),vs.(18±5),vs.(18±5),(P0.05)]。术后4周,D组患者ODI评分显著低于其他3组,差异有统计学意义[(9±2)vs.(18±3),vs.(13±2),vs.(15±3),(P0.05)]。D组患者VAS评分显著低于其他3组,差异有统计学意义[(3.3±0.6)vs.(5.4±0.8),vs.(4.3±0.7),vs.(4.2±0.7),(P0.05)]。D组患者术后48 h内引流量明显低于其他3组,差异有统计学意义[(316±41)vs.(457±51),vs.(420±56),vs.(391±48),(P0.05)]。结论:联合应用倍他米松和医用生物蛋白胶能够在神经根减压术中收获比单用药物更好的疗效。
[Abstract]:Objective: to evaluate the efficacy of betamethasone and biomedical bioprotein glue in nerve root decompression. Methods: 120 cases of lumbar nerve root decompression were observed. The patients were divided into 4 groups according to the different ways of treatment after operation. The patients were divided into 4 groups: group B and group B were treated with betamethasone alone, group C was treated with betamethasone alone, group D was treated with betamethasone combined with medical bioprotein glue. The straight leg elevation test angle, modified JOA score and ODI score and VAS score were observed in each group. The drainage flow was observed within 48 hours after operation, and the difference of examination results in each group was analyzed. Results: there was no significant difference in preoperative age, history duration, male to female ratio, straight leg elevation test angle, improved JOA score and ODI score and VAS score. There was no significant difference in drainage volume within 48 hours after operation. The angle of straight leg elevation test was significantly improved in each group after operation, and the difference was statistically significant (P 0.05). 4 weeks after operation, the motion angle of hip joint in group D was significantly higher than that in the other three groups, and the difference was statistically significant [75 卤23 掳vs.(54 卤19 掳/ vs.62 卤20 掳/ vs.64 卤21 掳P0.05], and the motor angle of knee joint in group D was significantly lower than that in the other three groups at 4 weeks after operation, and the motion angle of knee joint in group D was significantly lower than that in group D at 4 weeks after operation. The difference was statistically significant [11 卤4 掳vs.(16 卤6 掳vs.13 卤5 掳vs.14 卤5 掳P0.05], and the motion angle of hip joint in group D was significantly higher than that in group A 4 weeks after operation [74 卤21 掳vs.(54 卤19 掳P0.05]. The modified 7)vs.(16 scores in group D were significantly higher than those in the other three groups at 4 weeks after operation (P < 0.05). At 4 weeks after operation, the ODI scores of group D were significantly lower than those of the other three groups, and the difference was statistically significant [9 卤2)vs.(18 卤3ovs.13 卤2ovs.15 卤3 + P0.05] .VAS score of group D was significantly lower than that of the other three groups (3.3 卤0.6)vs.(5.4 卤0.8vs.4.3 卤0.7vs.f.42 卤0.7). The drainage volume in group D was significantly lower than that in the other three groups within 48 hours after operation, and there was a significant difference between group D and group D (P < 0.05), and there was a significant difference between group D and group D (P < 0.05), and the difference was significant (P < 0.05), and there was a significant difference between group D and group D (P < 0.05). The difference was statistically significant [316 卤41)vs.(457 卤51ovs.f.420 卤56ovs.391卤 48P0.05]. Conclusion: combined use of betamethasone and biomedical bioprotein glue is more effective than single drug in nerve root decompression.
【作者单位】：承德医学院附属医院脊柱外一科;
【分类号】：R687.3

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