超声引导体横下韧带松解联合腰椎旁阻滞治疗后外侧型腰椎间盘突出症  

Ultrasound-guided Inferior Corporotransverse Lingament Release Combined with LPVB for Posterolateral LDH

作　　者：姚晖 王智耀[2] 王楠[2] 朱瑜琪 朱立国[1] YAO Hui;WANG Zhiyao;WANG Nan;ZHUYuqi;ZHULiguo(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中国中医科学院眼科医院

出　　处：《中国中医骨伤科杂志》2019年第1期35-38,44,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：2010;2011年中医药行业科研专项项目"退行性腰椎滑脱症治疗康复一体化及推广应用研究"(201107004)

摘　　要：目的:通过对体横下韧带松解联合腰椎旁阻滞(LPVB)治疗后外侧型腰椎间盘突出症(LDH)疗效的随机对照研究,探讨该疗法的安全性和有效性。方法:将80例患者随机分为治疗组和对照组各40例。治疗组40例给予超声引导针刀松解联合LPVB治疗,每7d治疗1次,2次为1个疗程;对照组40例,给予超声引导LPVB治疗,每7d治疗1次,2次为1个疗程。记录治疗前、疗程结束时、疗程结束后3个月末的VAS评分和ODI评分并进行比较。结果:1)治疗前两组VAS评分及ODI评分差异均无统计学意义(P>0.05);2)疗程结束时两组的VAS平均分值均低于治疗前,差异有统计学意义(P<0.001),且两组VAS评分差异无统计学意义(P>0.05);两组的ODI平均分值均低于治疗前,差异有统计学意义(P<0.001),且治疗组低于对照组,差异有统计学意义(P<0.05);3)疗程结束后3个月末两组的VAS平均分值均低于治疗前,差异有统计学意义(P<0.001),且治疗组低于对照组,差异有统计学意义(P<0.05);治疗组ODI平均分值低于治疗前,差异有统计学意义(P<0.001),对照组ODI平均分值低于治疗前,差异有统计学意义(P<0.05),且治疗组低于对照组,差异有统计学意义(P<0.05)。结论:1)超声下体横下韧带松解结合LPVB治疗后外侧型LDH疗效确切,可有效改善患者的VAS和ODI评分,缓解患者疼痛,改善功能障碍;2)超声引导是针刀及LPVB等闭合性经皮治疗实现可视化的有效手段之一;3)体横下韧带压迫可能是引起后外侧型LDH出现疼痛、产生功能障碍的因素之一。Objective:A Randomized controlled study of the treatment of posterior lateral lumbar disc herniation(LDH)with inferior corporotransverse lingament release combined with lumbar paravertebral block(LPVB)to investigate the safety and efficacy of this therapy.Methods:80 inpatients were randomly divided into treatment group(40 cases),underwent ultrasound-guided acupotomy release combined with LPVB,once every 7 d,2 times for one course;40 cases in the control group,underwent ultrasound-guided LPVB,once every 7 d,2 times for a course.The VAS scores and ODI scores before the treatment,at the end of the treatment,and at the end of the third month after the end of the treatment were recorded and compared.Results:There were no differences in gender,age,and duration of disease between the two groups(P>0.05).1)Before treatment:There was no significant difference in VAS score and ODI score between the two groups(P>0.05).2)At the end of the course:the average VAS scores in two groups were lower than that before treatment(P<0.001),There was no significant difference in VAS scores between the two groups(P >0.05).The average score of ODI in two groups was lower than that before treatment(P<0.001),the ODI score in the treatment group was lower than that in the control group(P<0.05).3)At the end of the third month after the course:The average VAS score in two groups was lower than that before treatment(P<0.001).The VAS score of the treatment group was lower than the control group(P<0.05);the average score of ODI in the treatment group was lower than that before treatment(P<0.001).The average score of ODI in the control group was lower than that before treatment(P<0.05),and the ODI score of the treatment group was lower than the control group(P<0.05).Conclusion:1)Inferior corporotransverse lingament release combined with LPVB treatment of posterior lateral LDH is effective,can effectively improve patients’ VAS,ODI score,relieve pain and improve dysfunction.2)Ultrasound guidance is one of the effective means to visualize treatments

关 键 词：超声引导 体横下韧带 针刀 腰椎旁阻滞 后外侧型腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学]