X线引导下经椎间孔双针穿刺技术用于腰椎间盘突出症的临床研究  

CLINICAL STUDY OF FLUOROSCOPICALLY GUIDED DOUBLE-NEEDLE TECHNIQUE THROUGH INTERVERTEBRAL FORAMEN IN THE TREATMENT OF LUMBAR DISK HERNIATION

作　　者：李晓宏[1] 杨承祥[1] 王汉兵[1] 闫哲[1] 赵雪群[1] 富沛勇[2] 

机构地区：[1]广东省佛山市第一人民医院麻醉科,佛山528000 [2]广东省佛山市第一人民医院放射科,佛山528000

出　　处：《中国疼痛医学杂志》2004年第3期155-157,共3页Chinese Journal of Pain Medicine

摘　　要：目的 :探讨经椎间孔双针穿刺技术在治疗腰椎间盘突出症中的可行性。方法 :5 8例腰椎间盘突出症患者 ,随机分为两组。Ⅰ组经患侧小关节内侧缘或椎板外切迹进入硬膜外侧间隙 ,Ⅱ组在X线引导下用双针法进入患侧椎间孔。记录两组穿刺操作的时间、治疗前后的VAS疼痛评分及疗效评定。结果 :第一组平均穿刺时间明显高于第二组穿刺时间 (分别为 15 .6± 2 .8min和 11.3±1.6min ,P <0 .0 5 ) ,Ⅰ组的优良率和有效率分别为 73.3%和 86 .7% ,Ⅱ组的优良率和有效率分别为 82 .1%和 92 .9% ;两组VAS评分在治疗后都有明显下降 (P <0 .0 5 ) ,组间比较无显著性差异。结论 :X线引导下经椎间孔双针技术操作简单、安全、准确 ,效果确切 ,值得临床推广。Objective:To discuss the feasibility and safety of the the double-needle technique for the treatment of lumbar disk herniation. Methods:Firty-eight patients with LDH,36 males and 22 females,aged 25 to 56,were randomly divided into two groups. In group I,the protruded nucleus were treated by extradural space;in group II,they were treated by fluoroscopically guided double-needle technique through intervertebral foramen. The time of the procedure and the VAS before and after treatment in two groups were recerded,the therapeutic effects were evaluated at the same time. Result:The time of the procedure in groupⅠis significantly longer than that in group Ⅱ(15.6±2.8min vs 8.3±1.6min,P <0.05),The excellent and good rate was 76.2% in groupⅠand 85.6% in groupⅡ. The effective rate was 86.8% in groupⅠwhile it was 90.5% in groupⅡ. The VAS were significantly lower than that after injection in both groups( P <0.05),but it was not significantly different. Conclusion:The fluoroscopically guided double-needle technique through intervertebral foramen is easy and safe. It can make the puncture more accurate and effective.

关 键 词：X线引导 经椎间孔双针穿刺技术 腰椎间盘突出症 神经阻滞疗法 

分 类 号：R681.53[医药卫生—骨科学]