CT引导下连续硬膜外腔阻滞联合低温等离子射频治疗腰椎间盘突出症效果分析  

Effect of continuous epidural nerve block guided by CT combined with coblation in treatment of lumber disc herniation

作　　者：何明伟[1] 葛维鹏[2] 马骏[1] 

机构地区：[1]首都医科大学附属北京安贞医院麻醉中心,100029 [2] 胜利油田中心医院麻醉手术科

出　　处：《中国医药》2015年第4期539-542,共4页China Medicine

基　　金：北京市科技计划课题（Z121107001012159）;首都医学发展科研基金（2009-3145）;北京市卫生系统高层次卫生技术人才培养计划（2013-2-004）

摘　　要：目的 探讨CT引导下连续硬膜外腔阻滞联合低温等离子射频治疗腰椎间盘突出症的临床疗效.方法 选择首都医科大学附属北京安贞医院2014年3-6月收治的72例腰椎间盘突出症患者,根据随机数字表法分为A组和B组,各36例.A组接受CT引导下连续硬膜外腔阻滞后联合低温等离子射频治疗;B组仅接受低温等离子射频治疗.分别记录治疗前和治疗后1、3、6个月的疼痛视觉模拟量表（VAS）评分,分别于治疗后1、3、6个月对2组患者进行疗效评价.结果 治疗前和治疗后1、3、6个月的VAS评分分别为：A组（7.1 ± 1.5）、（1.2±0.5）、（1.8±0.6）和（2.1±1.2）分;B组（7.0±1.4）、（2.2±0.8）、（2.8±1.1）和（4.5±2.1）分.2组治疗后1、3、6个月的VAS评分都明显低于治疗前,A组明显低于B组,差异均有统计学意义（均P ＜0.05）;A、B组治疗后1、3、6个月的治疗优良率比较[100.0％（36/36）比80.6％（29/36）,91.7％（33/36）比75.0％（27/36）,86.1％（31/36）比75.0％（27/36）],差异均有统计学意义（均P＜0.05）.各组均无明显并发症发生.结论 CT引导下连续硬膜外腔阻滞联合低温等离子射频治疗腰椎间盘突出症中远期疗效优于单纯低温等离子射频治疗.Objective To study the effect of continuous epidural nerve block guided by CT combined with coblation in treatment of lumber disc herniation. Methods Totally 72 patients suffering from with lumber disc herniation were randomly divided into group A （36 patients） receiving continuous epidural nerve block guided by CT combined with coblation and group B （36 patients） receiving coblation only. The visual analogue scale （VAS） was assessed before treatment, 1,3 and 6 months after treatment, the treatment efficacies were evaluated 1, 3 and 6 months after treatment. Results The VAS scores was （7.1±1.5）, （1.2±0.5）, （1.8±0.6） and （2.1± 1.2） scores in groupA, （7.0±1.4）, （2.2±0.8）, （2.8±1.1） and （4.5±2.1） scores in group B before treatment, 1, 3 and 6 months after treatment. The VAS scores in both the two groups were significantly reduced compared with pretreatment and there were also statistical differences between the two groups （ all P 〈 0.05 ）. The excellent and good rates 1, 3 and 6 months after treatment were statistically different between group A and B [ 100.0% （36/36） vs 80.6% （29/36）, 91.7% （33/36） vs 75.0% （27/36）, 86.1% （31/36） vs 75.0% （27/36） ] （ P 〈 0.05 ）. No obviously complication occurred in both the two groups. Conclusion Continuous epi- dural nerve block guided by CT combined with coblation is superior to the coblation alone in treatment of lumber disc herniation.

关 键 词：腰椎间盘突出症 连续硬膜外腔阻滞 低温等离子射频 

分 类 号：R681.5[医药卫生—骨科学]