微创医学

目的观察单唾液酸四己神经节苷脂对椎管内麻醉所致外周神经损伤的治疗效果。方法选择骨科住院行下肢手术穿刺时出现神经症状患者75例,随机采用神经节苷脂治疗（A组）、甲钴胺注射液（弥可保）治疗（B组）及生理盐水对照（C组）,观察术后6 h、12 h、48 h和72 h时点疼痛、麻木和感觉异常评分。结果疼痛及麻木评分：A组术后12 h起评分低于B、C两组（P〈0.05或0.01）;B组疼痛评分术后72 h低于C组（P〈0.01）。感觉异常评分：A组术后24 h起低于B组,48 h起低于C组（P〈0.05或0.01）;B组术后72 h低于C组（P〈0.01）。三组在四个时段间的MAP、HR和SpO2值比较差异均无统计学意义（P〉0.05）。结论神经节苷脂能有效地促进椎管内麻醉引起外周神经损伤的恢复,优于单纯使用甲钴胺。

Objective To observe the therapeutic effects of ganglioside in the treatment of peripheral nerve injury after spinal anesthesia.Method 75 in-patient orthopedic patients with neurological symptoms were enrolled and randomly divided into Group A,treated with ganglioside,Group B,treated with mecobalamine,and Group C,treated with normal sodium.Pain,numbness and paresthesia score 6h,12h,48h and 72h after operation were observed.Results Pain and numbness score of Group A became less than that of the other two groups 12h after operation（P0.05 or 0.01）,and the score of Group B became less than that of Group C 72h after operation（P0.01）.Paresthesia score of Group A became less than that of Group B 24h after operation,and became less that that of Group C 48h after operation（P0.05 or 0.01）,and the score of Group B became less than that of Group C 72h after operation（P0.01）.There was no significant difference in MAP,HR and SpO2 values of four time points among three groups（P0.05）.Conclusion Gangliosides is effective in promoting spinal anesthesia caused by the recovery of peripheral nerve injury,better than the use of methylcobalamin only.

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