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目的:观察围手术期应用甲基强的松龙(MP)对脊柱转移瘤所致恶性脊髓压迫症患者脊髓神经功能恢复的作用。方法:2002年1月～2007年5月,在我院手术治疗的脊柱转移瘤所致恶性脊髓压迫症患者22例,13例采用一期后路椎管减压、肿瘤姑息切除手术治疗,减压前30min给予MP 1000mg冲击(用药组),术后第1天起予MP80～120mg静脉点滴,每日2次,共应用3～5d;同期9例未使用MP而其余处理相同的同类型患者作为对照组。对术前、术后1d、术后1周和术后1个月时两组患者的脊髓功能进行ASIA评分。结果:两组患者无围手术期死亡病例,全部病例随访2～27个月,用药组与对照组术前的ASIA评分无显著性差异(P>0.05),术后1d、1周和1个月时两组ASIA评分有显著性差异(P<0.05)。结论:对于脊柱转移瘤所致恶性脊髓压迫症患者,围手术期应用MP有利于保护脊髓神经功能。
Objective: To observe the effect of perioperative application of methylprednisolone (MP) on spinal neurological recovery in patients with malignant spinal cord compression due to spinal metastases. Methods: From January 2002 to May 2007, 22 patients with malignant spinal cord compression caused by spinal metastases underwent surgical treatment in our hospital. Thirteen patients underwent primary laminectomy and palliative resection. MP 1000mg given 30 minutes before the impact of pressure (medication group), the first day after MP80 ~ 120mg intravenous drip twice a day for a total of 3 ~ 5d; the same period in 9 cases without MP and the rest of the same type of treatment of patients As a control group. The ASIA scores of spinal cord function of the two groups were evaluated preoperatively, 1 day after operation, 1 week after operation and 1 month after operation. Results: There were no perioperative deaths in both groups. All patients were followed up for 2 to 27 months. There was no significant difference in preoperative ASIA scores between the two groups (P> 0.05) Month ASIA scores were significantly different (P <0.05). Conclusion: For patients with malignant spinal cord compression caused by spinal metastases, perioperative application of MP is conducive to the protection of spinal nerve function.