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目的 :探讨改良后的静脉大剂量氢化考的松与低分子右旋糖酐 (SD疗法 )治疗 Bell麻痹 (BP)的疗效 ,避免 SD疗法中出现的并发症。方法 :以改良 SD疗法治疗 BP患者 71例 (改良组 ) ,以口服类固醇激素治疗 32例BP患者作对照 (对照组 )。比较改良 SD疗法与文献中 SD疗法的疗效及出现的并发症的比率 ,比较改良组与对照组的疗效。结果 :BP患者 House- Brackmann ～ 级恢复率 ,改良组为 95 .8% ,对照组 81.2 % (P <0 .0 5 ) ;改良组的 71例中 ,发病后 2 4h内接受治疗者 I级恢复率为 75 .0 % ,2 4～ 48h为 43.8% ,2～ 3 d为 2 6 .7% ,3～ 5 d为18.8% ,第 1个时段者与其后 3个时段者比较 ,差异均有显著性意义 (P <0 .0 5 ) ;且无肝肾功能损害及消化道溃疡发生。结论 :于发病后 2 4h内进行改良 SD疗法 ,能提高 BP患者 ～ 级恢复率 ,缩短恢复时间 ,能避免原疗法中出现的肝肾功能损害及消化道溃疡等严重并发症。
Objective: To investigate the curative effect of modified intravenous bolus hydrocortisone and low molecular dextran (SD) in the treatment of Bell’s palsy (BP) and avoid the complications in SD therapy. Methods: A total of 71 BP patients treated with modified SD therapy (modified group) and 32 BP patients treated with oral steroid hormone as control (control group). To compare the efficacy of modified SD therapy with SD therapy in the literature and the incidence of complications, and to compare the efficacy of the modified and control groups. Results: The rate of House-Brackmann-class recovery in BP patients was 95.8% in the improved group and 81.2% in the control group (P <0.05). Among the 71 patients in the modified group, the level of I- The rates of recovery were 75.0%, 43.8% at 2-4-48 hours, 26.7% at 2-3 days and 18.8% at 3-5 days. The difference between the first period and the next three periods were (P <0. 05); and no liver and kidney dysfunction and peptic ulcer occurred. Conclusion: Improved SD therapy within 24 hours after onset can improve the recovery rate of stage ~ BP patients and shorten the recovery time, and can avoid serious complications such as liver and kidney dysfunction and peptic ulcer in the original therapy.