| 甲基强的松龙冲击疗法治疗放射性脑水肿的疗效 |
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| 引用本文： | 蔡,伦,熊左隽,李,俊,赵洪洋,蔡,琴.甲基强的松龙冲击疗法治疗放射性脑水肿的疗效[J].中国临床神经外科杂志,2020,0(7):443-446. |
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| 作者姓名： | 蔡 伦 熊左隽 李 俊 赵洪洋 蔡 琴 |
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| 作者单位： | 430014 武汉，华中科技大学同济医学院附属武汉中心医院神经外科（蔡 伦、熊左隽、李 俊）；430022 武汉，华中科技大学同济医学院附属协和医院神经外科（赵洪洋）；430070 武汉中国人民解放军中部战区总医院干部病房1科（蔡 琴） |
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| 摘 要： | 目的 探讨甲基强的松龙（MP）冲击疗法治疗放射性脑水肿（RCE）的临床疗效。方法 回顾性分析2001~2012年收治46例的RCE的临床资料。26例给予MP冲击疗法（观察组），20例给予地塞米松等传统治疗（对照组）。治疗30 d，评估临床疗效，分为显效、有效、无效、进展；总有效=显效+有效；根据中华医学会第二次全国脑血管病学术会议制定的评分标准评定神经功能缺损程度，分为基本治愈、显著进步、进步、无变化、恶化、死亡；采用修订的Barthel指数评定法评定日常生活活动能力。结果 观察组总有效率（90.91%）与对照组（72.22%）无统计学差异（P>0.05），但是显效率（36.26%）明显高于对照组（5.56%；P<0.05）。治疗后30 d，观察组神经功能评分（8.15±3.25）分]与对照组（7.65±3.77）分]较治疗前均明显降低（P<0.05），但两组之间无统计学差异（P>0.05）。治疗后30 d，观察组Barthel指数（84.04±12.41）分]与对照组（84.50±7.59）分]较治疗前均明显增高（P<0.05），但是两组之间无统计学差异（P>0.05）。观察组不良反应发生率（42.31%）与对照组（45.00%）无统计学差异（P>0.05）。结论 MP冲击疗法和传统地塞米松疗法对RCE均具有治疗作用，但MP冲击疗法对颅内压增高症状的改善更快、更明显
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| 关 键 词： | 放射性脑水肿 甲基强的松龙 地塞米松 疗效 |
Treatment of high-dose methylprednisolone for patients with radiation brain edema |
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| CAI Lun,XIONG Zuo-jun,LI Jun,ZHAO Hong-yang,CAI Qin..Treatment of high-dose methylprednisolone for patients with radiation brain edema[J].Chinese Journal of Clinical Neurosurgery,2020,0(7):443-446. |
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| Authors: | CAI Lun XIONG Zuo-jun LI Jun ZHAO Hong-yang CAI Qin |
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| Affiliation: | 1. Department of Neurosurgery, Central Hospital of Wuhan,Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; 2. Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and |
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| Abstract: | Objective To explore the clinical effect of high-dose methylprednisolone (MP) on radiation brain edema (RCE). Methods The clinical data of 46 patients with RCE who were admitted to our hospital from 2001 to 2012 were retrospectively analyzed. Twenty-six patients received high-dose MP (observation group), and 20 patients received dexamethasone (control group). Thirty days after the treatment, the clinical efficacy was evaluated and divided into four levels including significant effectiveness, effectiveness, ineffectiveness, and progress; total effectiveness=significant effectiveness+effectiveness; he degree of neurological deficit was evaluated according to the scoring criteria developed by the Second National Cerebrovascular Disease Academic Conference of the Chinese Medical Association, which was divided into six levels including cure, significant progress, progress, no change, deterioration, and death; the revised Barthel index assessment method was used to assess the activities of daily living. Results There was no significant difference in the rate of total effective between observation group (90.91%) and control group (72.22%; P>0.05), but the rate of significant effctiveness in observation group (36.26%) was significantly higher than that (5.56%) in control group (P<0.05). Thirty days after the treatment, the neurological function score and Barthel index were significantly higher in both groups than before treatment (P<0.05), but there was no statistical difference between the two groups (P>0.05). There was no significant difference in the incidence of adverse reactions between observation group (42.31%) and control group (45.00%; P>0.05). Conclusion High-dose MP and dexamethasone are both effective treatments for RCE, but MP improves the symptoms of intracranial hypertension more quickly and obviously |
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| Keywords: | Radioactive cerebral edema High-dose methylprednisolone Dexamethasone Clinical effect |
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