超声联合低剂量CT引导下腰脊神经根射频术治疗下肢根性痛的疗效分析  

Clinical Effect Analysis of Radiofrequency Therapy of Lumbar Spinal Nerve Guided by Ultrasound and Low-dose CT for Lower Extremity Radicular Pain

作　　者：银潇 曹光雄 易芳 YIN Xiao;CAO Guangxiong;YI Fang(Pain Department,Leshan Geriatric Hospital,Leshan,Sichuan,614000)

机构地区：[1]乐山老年病专科医院疼痛科,四川乐山614000

出　　处：《智慧健康》2022年第27期5-9,共5页Smart Healthcare

摘　　要：目的评价超声联合低剂量CT引导下腰脊神经根射频术治疗下肢根性疼痛的临床疗效及经验总结。方法选择乐山老年病专科医院疼痛科2019年3~9月单侧下肢根性痛患者40例,年龄、性别不限,随机分为观察组及对照组。观察组实施超声联合低剂量CT引导下神经根射频术治疗,对照组实施体表定位腰椎旁阻滞治疗,分析两组患者治疗后1天、1周、1个月及3个月的临床疗效及疼痛VAS评分。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05),观察组疼痛指标优于对照组,差异有统计学意义(P<0.05);两组患者术前外周血CD4~+/CD8~+比值、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);观察组术后24h、72h外周血CD4~+/CD8~+比值(2.32±0.28、2.52±0.35)明显高于对照组(1.63±0.18、1.72±0.22),TNF-α[(420.02±36.53)ng/L、(449.76±39.85)ng/L]、IL-6水平[(42.26±3.92)ng/L、(45.36±4.04)ng/L]明显低于对照组[(496.12±35.68)ng/L、(530.25±39.68)ng/L、(50.15±4.44)ng/L、(53.88±3.96)ng/L],差异均有统计学意义(P<0.05)。结论超声联合低剂量CT引导下腰神经根射频术治疗安全性高,疗效确切,联合了超声实时操作穿刺、CT验证靶点位置的优势,降低患者辐射伤害,值得临床进一步推广与探讨。Objective To evaluate clinical effect and experience of radiofrequency therapy of lumbar spinal nerve root under guidance of ultrasound and low-dose CT in treatment of lower extremity root pain.Methods The paper chose 40 patients with unilateral lower extremity root pain from March 2019 to September 2019 in pain department of Leshan Geriatric Hospital,and divided them into observation group and control group randomly.Observation group was treated with ultrasound and low-dose CT guided nerve root radiofrequency and block,and control group with body surface localized paraspinal block.Clinical effect and pain VAS scores between two groups were analyzed at 1 day,1 week,1 month and 3 months after treatment.Results Total effective rate of observation group was higher than control group(P<0.05),pain index of observation group was better than control group(P<0.05);peripheral blood CD4/CD8ratio and TNF-αand IL-6 comparison showed no significant difference before operation,(P>0.05).Ratio of CD4/CD8in peripheral blood(2.32±0.28,2.52±0.35)in observation group was significantly higher than control group(1.63±0.18,1.72±0.22)at 24h and 72h after operation.TNF-α[(420.02±36.53)ng/L、(449.76±39.85)ng/L]、IL-6 levels[(42.26±3.92)ng/L,(45.36±4.04)ng/L]were significantly lower than control group[(496.12±35.68)ng/L,(530.25±39.68)ng/L,(50.15±4.44)ng/L,(53.88±3.96)ng/L],difference was statistically significant(P<0.05).Conclusion Ultrasound combined with low-dose CT guided radiofrequency and block therapy of lumbar nerve root is safe and effective,which combines advantages of ultrasound real-time operation puncture and CT to verify target position,can reduce radiation injury of patients,which is worthy of further promotion and discussion in clinical practice.

关 键 词：超声联合低剂量CT引导 脉冲射频 下肢根性痛 

分 类 号：R687.3[医药卫生—骨科学]