C臂透视引导下注射型针刀治疗神经根型颈椎病的临床研究  

Clinical Research of Injection-type Needle-knife in Treatment of Cervical Spondylotic Radiculopathy Guided by C-arm Fluoroscopy

作　　者：卢笛[1] 徐卫星[1] 丁伟国 朱华东[1] 郭峭峰[1] 马苟平[1] 祝卫民[1] 

机构地区：[1]浙江省立同德医院骨科,浙江杭州310012 [2]桐乡市第一人民医院骨科,浙江桐乡314500

出　　处：《中华中医药学刊》2013年第12期2677-2679,I0024-I0025,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科学研究基金资助项目(2011ZA002)

摘　　要：目的:研究C臂透视引导下注射型针刀颈后侧入路椎旁神经阻滞及小关节突周围软组织松解治疗神经根型颈椎病的临床疗效。方法:2011年7月—2012年5月治疗神经根型颈椎病的患者90例,其中C臂透视引导下注射型针刀颈后侧入路椎旁神经阻滞及小关节突周围软组织松解治疗30例,C臂透视引导下颈后侧入路椎旁神经阻滞治疗30例,C臂透视引导下针刀松解治疗30例;对所有患者在治疗前、治疗后1周、1月、6月进行评分。结果:根据《神经根型颈椎病疗效评定指标体系》进行评分,结果显示治疗前三组患者的评分无统计学差异(P=0.776>0.05);治疗后1周和1个月的评分显示注射型针刀组疗效显著,且有统计学意义(P=0.000<0.05);治疗后6月的评分显示注射型针刀组的疗效虽也有下降,但仍优于单纯阻滞组和单纯针刀组,且有统计学意义(P=0.000<0.05)。结论:采用C臂透视引导下注射型针刀颈后侧入路椎旁神经阻滞及小关节突周围软组织松解治疗神经根型颈椎病比单纯阻滞治疗和针刀治疗具有更好的疗效。Objective ： To research the clinical efficacy of using injection - type needle - knife to block the paravertebral nerve and release the cervical zygapophysial soft tissue guided by C - arm fluoroscopy in neck posterior approach to treat cervical spondylotie radiculopathy （CSR）. Methods ： From July 2011 to May 2012,90 CSR patients were divided into three groups： 30 patients were treated by injection- type needle -knife to block the paravertebral nerve and release the cervical zygapophysial soft tissue guided by C -arm fluoroscopy ;30 patients were treated by injecting to block the paraver- tehral nerve;30 patients were treated by using needle -knife to release the cervical zygapophysial soft tissue guided by C - ann fluoroscopy. We analyzed all patients scores before treatment, 1 week, 1 month, 6 months after treatment. Results ： According to the evaluation index system of cervical spondylotic radieulopathy, the results showed that scores of three groups had no significant difference （ P = 0.776 〉 0.05 ） before treatment, after 1 week and 1 month, the scores of three groups had significant difference （P = 0. 000 〈 0.05 ）, and the scores of injection -type needle -knife group were higher than that of the other two groups. After 6 months, the scores of injection - type needle - knife group were declined, but these were superior to that of the other two groups, and they were significantly different（ P = 0. 000 〈 0.05 ）. Conclusion： Using injection - type needle - knife to block the paravertebral nerve and release the cervical zygapophysial soft tissue guided by C - arm fluoroscopy in neck posterior to treat CSR could get more efficacy than using needle - knife and simple injecting.

关 键 词：C臂透视 注射型针刀 针刀 椎旁神经阻滞 神经根型颈椎病 

分 类 号：R245.9[医药卫生—针灸推拿学]