选择性神经根阻滞术治疗骨质疏松椎体压缩性骨折疼痛的效果  

Selective nerve-root block for the relief of pain resulting from osteoporotic vertebral fractures

作　　者：薛祥云[1] 左小华[1] 张前西 赵红霞[1] 王茜[1] 陈波涛[1] 马柯[1] 宗菁[1] 

机构地区：[1]江苏省淮安市第二人民医院疼痛科,223002

出　　处：《中华麻醉学杂志》2012年第11期1302-1303,共2页Chinese Journal of Anesthesiology

摘　　要：选择骨质疏松椎体压缩性骨折患者23例，年龄65～90岁，体重51～78kg，取俯卧位或侧卧位，暴露胸背部或腰背部，在C型臂机辅助下应用0．5％利多卡因＋甲钻胺0．5mg＋倍他米松磷酸钠注射液5．26mg的混合液6～8ml行选择性神经根阻滞术。术前、术后即刻、1周、1月和3月时VAS评分分别为8．6±0．9、1．5±0.7、2．8±0．9、1．6±0．5和（2．5±0．7）分，与术前比较，术后各时点VAS评分降低（P〈0．05）。改良MacNab疗效评定标准评估术后优良率均为87％。术中和术后未见出血、血肿、感染、气胸、血气胸、头痛等不良反应发生。选择性神经根阻滞术治疗骨质疏松性椎体压缩性骨折疼痛效果确切。Twenty-three patients with pain from osteoporotic vertebral fractures, aged 65-90 yr, weighing 51-78 kg, received an image intensifier-assisted nerve-root block with a 6-8 ml mixture of 0.5 % lidocaine, meco- balamine 0.5 mg and betamethasone sodium phosphate injection 5.26 mg in a prone or lateral position. The VAS scores before operation, at 0, 1 week, 1 and 3 months after operation were 8.6 ± 0.9, 1.5± 0.7, 2.8± 0.9, 1.6± 0.5 and 2.5 ±0.7, respectively. VAS scores were significantly lower at each time pint after operation than before operation （ P 〈 0.05） . According to modified MaeNab standard, the effectiveness of treatment was rated as excellent/good in 87% of the patients. No complication such as bleeding, hematoma, infection, pneumothorax, hemopneumothorax, headache was found during or after operation. Selective nerve-root block is effective in the treatment of pain resulting from osteoporotic vertebral fractures in patients.

关 键 词：神经传导阻滞 骨质疏松 骨折 压缩性 

分 类 号：R687.3[医药卫生—骨科学]