C臂X线机引导下骶髂关节穿刺治疗强直性脊柱炎的方法及疗效评价  

Evaluation the therapeutic effect of ankylosing spondylitis treated with sacroiliac joint injection under C-arm X-ray guidance

作　　者：李丹[1] 张婷婷[1] 陈爱华[1] 宋书林[2] 

机构地区：[1]三峡大学人民医院放射科,湖北宜昌443000 [2]三峡大学人民医院风湿免疫科,湖北宜昌443000

出　　处：《中国医师进修杂志》2015年第9期647-651,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究C臂X线机引导下骶髂关节穿刺治疗强直性脊柱炎的方法和疗效。方法强直性脊柱炎患者483例，按治疗方法分为两组，骶髂关节注药组（A组）421例采用C臂x线机引导下骶髂关节穿刺注射复方倍他米松注射液或曲安奈德＋甲氨蝶呤，同时口服柳氮磺吡啶；口服药物组（B组）62例口服柳氮磺吡啶＋美洛昔康。观察两组患者治疗前与治疗后3d、1周、2周、3周、4周及3个月的自我评价、指地距、Schober征、红细胞沉降率、C反应蛋白（CRP）等指标的变化情况。结果A组患者自我评价和指地距在治疗后3d与治疗前[（6．18±0．55）分比（8．89±0．53）分、（30．10±3．94）cm比（50．20±3．93）cm]比较差异有统计学意义（P〈0．05），Schober征、枕墙距在治疗后1周与治疗前[（3．44±0．32）cm比（3．19±0．47）cm、（9．49±0．68）cm比（10．72±2．36）cm]比较差异有统计学意义（P〈0．05）；B组患者自我评价和指地距在治疗后1周与治疗前[（7．07±0．72）分比（9．08±0．46）分、（48．14±5．62）cm比（50．84±4．33）cm]比较差异有统计学意义（P〈0．05），Schober征在治疗后4周与治疗前[（3．49±0．56）cm比（3．22±0．58）cm]比较差异有统计学意义（P〈0．05），枕墙距在治疗后2周与治疗前[（9．08±1．54）cm比（10．11±1．58）cm]比较差异有统计学意义（P〈0．05）。结论C臂x线机引导下骶髂关节注药治疗强直性脊柱炎是一种有效可行的方法。Objective To study the therapeutic effect of ankylosing spondylitis treated with sacroiliac joint injection under C-arm X-ray guidance. Methods Four hundred and eighty-three patients of ankylosing spondylitis were divided randomly into two groups according to the treatment method. Four hundred and twenty-one cases were in group A ： sacroiliac joint injection under C-arm X-ray, the injection medicine were diprospan or triamcinolone acetonide and methotrexate, and with oral sulfasalazine （SASP） as well. Sixty-two cases were in group B： oral medicion SASP and meloxicam alone without injection. Self-evaluation, finger- to-floor distance, changes in Schober＇s sign, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） before and after treatment of 3 d, 1 week,2 weeks, 3 weeks, 4 weeks and 3 months were observed. Results Two indicators including self-evaluation and finger-to-floor distance at initial 3 d were significantly lower than those before treatment in group A： （6.18 ± 0.55） scores vs. （8.89 ± 0.53） scores, （30.10 ± 3.94） cm vs. （50.20 ±3.93） cm, P 〈 0.05. Schober＇s sign and oeeiput-to-wall distance at 1 week after treatment were significantly lower than those before treatment in group A：（3.44 ±0.32） cm vs.（3.19±0.47） cm, （9.49 ± 0.68） cm vs. （10.72 ± 2.36） cm, P〈 0.05. Two indicators including self-evaluation and finger-to-floor distance at 1 week after treatment were significantly lower than those before treatment in group B： （7.07 ± 0.72） scores vs. （9.08 ± 0.46） scores, （48.14 ± 5.62） cm vs. （50.84 ± 4.33） cm, P 〈 0.05. Sehober＇s sign at 4 weeks after treatment was significantly lower than that than before treatment in group B：（3.49 ± 0.56） cm vs. （3.22 ± 0.58） cm, P 〈 0.05. Occiput-to-wall distance at 2 weeks after treatment was significantly lower than that before treatment in group B：（9.08 ± 1.54） cm vs. （10.11 ± 1.58） cm, P 〈 0.05. Conclusion The method of C-arm X-ray guided

关 键 词：骶髂关节 脊柱炎 强直性 穿刺术 治疗结果 

分 类 号：R593.23[医药卫生—内科学]