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利鲁唑联合甘露醇及高压氧治疗急性脊髓损伤的临床疗效观察

An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury.

作者信息

Li Huan-Xia, Cui Jing, Fan Jing-Shi, Tong Jian-Zhou

机构信息

Huan-xia Li, Department of Neurosurgery, West Part, Baoding First Central Hospital, Baoding, 071000, Hebei, P.R. China.

Jing Cui, Department of Neurosurgery, West Part, Baoding First Central Hospital, Baoding, 071000, Hebei, P.R. China.

出版信息

Pak J Med Sci. 2021 Mar-Apr;37(2):320-324. doi: 10.12669/pjms.37.2.3418.

Abstract

OBJECTIVE

To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI).

METHODS

From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated.

RESULTS

After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05).

CONCLUSIONS

For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury.

摘要

目的

探讨利鲁唑联合甘露醇及高压氧治疗胸腰椎骨折所致急性脊髓损伤(ASCI)的临床疗效。

方法

选取2015年6月至2018年5月在保定市第一中心医院接受治疗的80例胸腰椎骨折合并ASCI患者。所有患者均接受后路椎板切除术及螺钉内固定,并采用随机数字表法将其随机分为两组。对照组接受术后常规治疗,试验组在常规治疗基础上采用利鲁唑联合甘露醇及高压氧治疗。观察并评估两组患者治疗前及治疗4周后神经功能(包括运动功能和感觉功能)的恢复情况,以及血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、脑源性神经营养因子(BDNF)、碱性成纤维细胞生长因子(BFGF)等因子的变化。

结果

治疗后,两组患者的运动功能评分和感觉功能评分均较治疗前有所改善(p<0.05)。试验组与对照组相比改善明显,差异有统计学意义(p<0.05)。试验组IL-6、BDNF及NFGF水平明显低于对照组(p<0.05)。

结论

对于接受椎板减压固定术的胸腰椎骨折合并ASCI患者,利鲁唑联合甘露醇及高压氧的综合治疗方案具有一定优势。与传统疗法相比,其可能显著改善患者的运动和感觉功能,减轻脊髓炎症反应,促进损伤恢复。

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