射频热凝术联合硬膜外阻滞治疗腰椎间盘突出症的临床疗效观察  

Clinical observation of efficacy of radiofrequency thermo-coagulation(RA) combined with epidural block for treatment of lumbar disc herniation

作　　者：杜海艳[1] 宋宗和 左会明[1] 

机构地区：[1]佳木斯大学附属第一医院麻醉科,黑龙江佳木斯154003 [2]黑龙江省农垦红兴隆管理局中心医院疼痛科,黑龙江友谊155811

出　　处：《黑龙江医药科学》2013年第2期45-47,共3页Heilongjiang Medicine and Pharmacy

摘　　要：目的:观察X线引导下射频热凝术联合硬膜外阻滞治疗腰椎间盘突出症(Lumbar Disc herniation,LDH)的临床疗效,并观察在射频热凝术基础上,进行硬膜外前间隙阻滞与硬膜外后间隙阻滞治疗LDH的效果比较。方法:LDH患者60例,均分为三组:A组行单纯射频热凝术;B组射频热凝术联合硬膜外后间隙阻滞治疗;C组射频热凝术联合硬膜外前间隙阻滞治疗。术前,术后3天、2周、3个月、6个月测定疼痛视觉模拟评分(VAS),观察临床疗效及不良反应。结果:三组患者术后VAS评分较术前均明显降低,有统计学差异(P<0.05)。C组术后3d、2周、3个月、6个月VAS评分较A、B两组降低更明显(P<0.05),B组效果也优于A组(P<0.05)。A组术后2周、3个月、6个月优良率分别为:16/20、15/20、14/20。B组术后2周、3个月、6个月优良率分别为18/20、17/20、16/20。C组术后2周、3个月、6个月优良率分别为20/20、19/20、18/20。C组术后2周、3个月、6个月优良率均较A组与B组高。治疗后三组患者均无严重不良反应发生。结论:X线引导下射频热凝术联合硬膜外前后间隙阻滞治疗LDH效果较单纯射频热凝术好,尤其射频热凝术联合硬膜外前间隙阻滞效果更佳,值得临床推广应用。Objective： To observe the clinical efficacy of treatment by the X--ray guided RA combined with epidural block therapy in patients with LDH, and compare the effect between the epidural space anterior block and the traditional epidural block based on RA in patients with LDH. Methods： 60 patients with LDH were e- qually divided into three groups： group A received RA only; group B received RA combined with traditional epidural block; group C received RA combined with epidural space anterior block. Therapeutic parameters, in- cluding visual analogue score （VAS）, clinical efficacy and adverse reactions, were evaluated at preoperative, 3 days, 2 weeks and at 3, 6 months after the treatment. Results： VAS were significantly decreased at 3 days, 2 weeks and 3, 6 months after treatment in all the three groups when compared with preoperative baseline （P ~ 0.05）. VAS were also significantly decreased in group C at 3 days, 2 weeks, and 3 , 6 months after treatment than the other two groups （group A and group B） （P 〈 0.05）. The effect of group A was the worst （P 〈 0.05）. Global evaluation of excellent rate at 2 weeks, 3 and 6months after treatment were： 16/20, 15/20, 14/20 in group A. 18/20, 17/20, 16/20 in group B. 20/20, 19/20, 18/20 in group C, successively. Conclusion： X-- ray guided RA combined with epidural block provided better effect than RA only for the treatment of LDH, and X-- ray guided RA combined with epidural space anterior block has a better effect than RA combined with traditional epidural block.

关 键 词：腰椎间盘突出症 射频热凝术 硬膜外前间隙阻滞 

分 类 号：R681.53[医药卫生—骨科学]