甲钴胺和地塞米松治疗腰-硬联合麻醉后神经根损伤早期疗效评价

目的:探讨腰-硬联合麻醉穿刺时神经根损伤早期阶段的治疗方法。方法:48例腰-硬联合麻醉穿刺过程中出现神经根损伤的剖宫产患者,随机等分为两组(n=24),Ⅰ组保留硬膜外导管,术毕即刻硬膜外腔注射地塞米松5mg,每日一次;Ⅱ组不保留硬膜外导管,术毕立即肌注甲钴胺0.5mg,每日一次,观察记录5天后患者神经功能恢复情况。结果:Ⅰ组优良率95.8%;Ⅱ组优良率91.7%,两组比较差异无统计学意义(P>0.05)。结论:甲钴胺和地塞米松用于腰-硬联合麻醉穿刺过程中神经根损伤早期神经功能恢复阶段,均取得了满意的效果。

Assessment of Efficacy of Mecobalamin and Dexamethasone on Nerve Root Injury at the Early Stage during the Combined Spinal and Epidural Anesthesia

Objective:To explore the method about the early stages of treatment on nerve root injury caused by puncturing during the combined spinal and epidural anesthesia.Methods:Forty-eight parturients undergoing cesarean section,which had suspected nerve root injury caused by puncturing during the combined spinal and epidural anesthesia,were randomly divided into two groups of 24 patients each.Group Ⅰ was kept epidural anesthetic catheter and was given an epidural injection of dexamethasone at a dose of 5mg after operation,once per day;while group Ⅱ was not kept epidural anesthetic catheter and was given an intramuscular injection of mecobalamin at a dose of 0.5mg after operation,once per day.Patients neural function recovery was recorded after five days.Results:The group Ⅰ was found that the excellent and well rate was 95.8%;while group Ⅱ was found that the excellent and well rate was 91.7%,There was no significant difference in the total effective rate between the two groups(P>0.05).Conclusion:Both mecobalamin and dexamethasone are effective at neural function recovery in the early stages after nerve root injury caused puncturing during combined spinal and epidural anesthesia.