本文選題：倍他米松 + 醫(yī)用生物蛋白膠　； 參考：《中國醫(yī)院藥學雜志》2017年08期

【摘要】：目的:評價在神經(jīng)根減壓術(shù)中聯(lián)合應(yīng)用倍他米松和醫(yī)用生物蛋白膠的療效。方法:觀察對象為腰椎神經(jīng)根減壓術(shù)術(shù)后的120例患者,根據(jù)術(shù)后處理方式的不同將患者分為4組:A組單純手術(shù)組,B組單純應(yīng)用倍他米松組,C組單純應(yīng)用醫(yī)用生物蛋白膠組,D組倍他米松聯(lián)合應(yīng)用醫(yī)用生物蛋白膠組。觀察各組術(shù)后直腿抬高試驗角度、改良JOA評分、ODI評分、VAS評分、術(shù)后48 h內(nèi)引流量,分析各組檢查結(jié)果的差異。結(jié)果:術(shù)前患者年齡、病史時程、男女比例、直腿抬高試驗角度、改良JOA評分、ODI評分、VAS評分、術(shù)后48 h內(nèi)引流量均無統(tǒng)計學意義。術(shù)后各組患者直腿抬高試驗角度在不同時期均有明顯改善,差異有統(tǒng)計學意義(P0.05)。術(shù)后4周,D組患者髖關(guān)節(jié)運動角度顯著高于其他3組,差異有統(tǒng)計學意義[(75±23)°vs.(54±19)°,vs.(62±20)°,vs.(64±21)°,(P0.05)];術(shù)后4周,D組患者膝關(guān)節(jié)運動角度顯著低于其他3組,差異有統(tǒng)計學意義[(11±4)°vs.(16±6)°,vs.(13±5)°,vs.(14±5)°,(P0.05)];術(shù)后4周,D組患者髖關(guān)節(jié)運動角度顯著高于A組,差異有統(tǒng)計學意義[(74±21)°vs.(54±19)°,(P0.05)]。術(shù)后患者癥狀也有顯著改善:術(shù)后4周,D組患者改良JOA評分顯著高于其他3組,差異有統(tǒng)計學意義[(22±7)vs.(16±6),vs.(18±5),vs.(18±5),(P0.05)]。術(shù)后4周,D組患者ODI評分顯著低于其他3組,差異有統(tǒng)計學意義[(9±2)vs.(18±3),vs.(13±2),vs.(15±3),(P0.05)]。D組患者VAS評分顯著低于其他3組,差異有統(tǒng)計學意義[(3.3±0.6)vs.(5.4±0.8),vs.(4.3±0.7),vs.(4.2±0.7),(P0.05)]。D組患者術(shù)后48 h內(nèi)引流量明顯低于其他3組,差異有統(tǒng)計學意義[(316±41)vs.(457±51),vs.(420±56),vs.(391±48),(P0.05)]。結(jié)論:聯(lián)合應(yīng)用倍他米松和醫(yī)用生物蛋白膠能夠在神經(jīng)根減壓術(shù)中收獲比單用藥物更好的療效。
[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 鹵23 擄vs.(54 鹵19 擄/ vs.62 鹵20 擄/ vs.64 鹵21 擄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 鹵4 擄vs.(16 鹵6 擄vs.13 鹵5 擄vs.14 鹵5 擄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 鹵21 擄vs.(54 鹵19 擄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 鹵2)vs.(18 鹵3ovs.13 鹵2ovs.15 鹵3 + P0.05] .VAS score of group D was significantly lower than that of the other three groups (3.3 鹵0.6)vs.(5.4 鹵0.8vs.4.3 鹵0.7vs.f.42 鹵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 鹵41)vs.(457 鹵51ovs.f.420 鹵56ovs.391鹵 48P0.05]. Conclusion: combined use of betamethasone and biomedical bioprotein glue is more effective than single drug in nerve root decompression.
【作者單位】： 承德醫(yī)學院附屬醫(yī)院脊柱外一科;
【分類號】：R687.3

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