强直性脊柱炎骶髂关节内皮质激素注射疗效观察  

An observation of CT guided sacroiliac joint corticosteriod injection in patients with ankylosing spondylitis.

作　　者：王庆文[1] 曾庆馀[1] 刘源[2] 肖征宇[1] 陈肃标[1] 许杰洲[1] 林玲[1] 黄少弼[1] 

机构地区：[1]汕头大学医学院第一附属医院风湿科,515031 [2]汕头大学医学院第一附属医院放射科,515031

出　　处：《中国实用内科杂志》2001年第12期721-722,共2页Chinese Journal of Practical Internal Medicine

基　　金：广东省医学科研基金资助项目 (编号 :2 0 0 0 10 0 )

摘　　要：目的　了解强直性脊柱炎 (AS)骶髂关节 (SIJ)内皮质激素注射的疗效。方法　患者取俯卧位 ,在CT导引下穿刺SIJ滑膜部 ,取组织标本后 ,在CT导引下原路进入SIJ ,每侧注入丙酮缩去炎舒松 15mg。记录分析病人术前、术后临床资料。结果　 2 8例中 2 2例 (78 6 % )疼痛明显减轻 ,晨僵、夜间痛、SIJ压痛、“4”征、ESR升高及需使用NSAIDs的例数均较术前明显减少。所有SIJ标本均有炎症表现。结论　SIJ关节内注射长效激素 ,可作为对NSAIDs不耐受或无效的AS和uSpA病人的一种有效的缓解腰背痛手段 ,同时uSpA病人SIJ病理标本的获得 。Objectives To evaluate the therapeutic efficacy of CT guided corticosteroid injection for sacroiliitis in patients with ankylosing spondylitis(AS).Methods The patient was placed in a prone position.Guided by CT,the biopsy needle tip was posited in the synovium compartment of sacroiliac joint(SIJ).After getting the tissue samples,15mg triamcinolone acetonide was injected into each joint.All patients underwent continuous clinical follow-up at 4 to 12week-intervals after the intervention.The pathological feature and the clinical data were recorded and analyzed.Results Of the 28 cases,in which 10 cases with normal/suspected CT sacroiliitis and 18 cases with definite radiological sacroiliitis,all samples were found the evidences of inflammation in SIJ.These include synovitis,local cartilage degeneration,fibrosis,subchondral bony plate inflammatory and destruction.22 of the 28 cases(78 6%) showed a statistically significant abatement of subjective complaints.The case number of night pain,morning stiffness,pain in SIJ,'4'sign and the dose of the nonsteroid anti-inflammation drugs were demonstrated a statistically significant reduction.Conclusions CT guided SIJ corticosteroid injection is an effective local treatment for sacroiliitis.Pathological examination can improve the threshold of early diagnosis of sacroiliitis in case of CT normal/susceptive sacroiliitis.

关 键 词：强直性脊柱炎 骶髂关节炎 关节内注射 

分 类 号：R593.230.5[医药卫生—内科学] R977.1[医药卫生—临床医学]