DSA引导射频热凝联合硬膜外腔神经阻滞治疗腰椎间盘突出症的观察  

OBSERVATION OF DSA-GUIDING RADIOFREQUENCY THERMOCOAGULATION COMBINED WITH EPIDURAL BLOCK FOR TREATMENT OF LUMBAR INTERVERTEBRAL DISC HERNIATION

作　　者：韩丽丽[1] 杨晓秋[1] 刘小男[1] 宋云[1] 刘茂林[1] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,重庆400016

出　　处：《中国疼痛医学杂志》2011年第6期352-356,共5页Chinese Journal of Pain Medicine

摘　　要：目的:观察数字减影血管造影(DSA)引导射频热凝联合硬膜外腔神经阻滞治疗腰椎间盘突出症(Lumbar intervertebral disc herniation,LDH)的临床疗效及对患者血浆β-内啡肽的影响。方法:97例LDH患者随机分为两组:射频热凝联合硬膜外腔神经阻滞治疗组(R组)及单纯硬膜外腔神经阻滞治疗组(E组)。治疗前后进行VAS评分,观察近、中期疗效及不良反应。每组随机取7例患者检测治疗前后血浆β-内啡肽含量,并与健康人对照。结果:两组患者治疗后VAS评分较治疗前均明显降低,有显著性差异(P<0.01)。治疗后R组优良率明显高于E组。两组患者均无严重不良反应发生。两组患者治疗前血浆β-内啡肽含量均明显低于健康人,治疗后升高,第16天与治疗前相比有显著差异(P<0.05)。结论:射频热凝联合硬膜外腔神经阻滞治疗LDH治疗后血浆β-内啡肽有升高趋势,近、中期疗效确切,安全性高。Objective： To observe the clinical efficacy of radiofrequency thermocoagulation（RA） guided with digital substraction angiography（DSA） combined with epidural block（EB） for treating lumbar intervertebral disc herniation,and to explore the relationship between serum β-endorphin（β-EP） level and clinical efficacy.Methods： Ninty seven patients of Lumbar disc herniation were randornly divided into two groups： RA combined with EB group（group R） and the EB group（group E）.The VAS scores,clinical efficacy and complications were evaluated.Levels of serum β-EP were evaluated randomly for seven patients in each group.The normal group（N） contain five healthy people.Results： VAS scores of both groups decreased significantly after the treatment as compared with those before the treatment.The satisfactory rates in the group R were higher than those in the group E.There was no complication in each group.Before treatment,levels of serum β-EP were lower in both treatment groups than those in healthy persons.After treatment,serum β-EP levels were raised,and significant differences on were obsered the 16th day compared with before treatment.Conclusion： RA combined with EB is a safe and efficacious treatment for LDH in short-and middle term obserivation.Serum β-endorphin is increased after the treatment.

关 键 词：数字减影血管造影(DSA) 射频热凝 腰椎间盘突出症 Β-内啡肽 

分 类 号：R614[医药卫生—麻醉学]