经椎间孔选择性神经根阻滞术与保守疗法治疗神经根型颈椎病对照研究  

A case-control study between transforaminal selective nerve root block and conservative treatment for spondylotic cervical radiculopathy

作　　者：王帅 刘璐[2] 

机构地区：[1]解放军第二0二医院骨科,辽宁沈阳110003 [2]沈阳军区总医院医务部,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第3期230-233,共4页Clinical Journal of Medical Officers

摘　　要：目的比较经椎间孔选择性神经根阻滞术与保守疗法在治疗神经根型颈椎病中的方法和临床疗效。方法回顾性分析自2011年1月至2013年12月解放军202医院骨科收治的79例神经根型颈椎病患者的临床资料。其中,36例接受经椎间孔选择性神经根阻滞术,设为A组;43例接受保守疗法,设为B组。治疗后1周、3个月、6个月对所有患者进行随访,比较两组患者随访时的颈部功能(NDI)评分、颈痛及上肢痛的视觉模拟(VAS)评分。结果 A组手术时间(36.0±4.1)min,术中出血量(13.6±1.2)ml;其中,药物过敏性皮疹1例,手术失败3例。B组平均住院治疗5 d;药物不良反应10例,其中,血糖升高5例、双下肢水肿3例、急性胃炎2例;治疗失败3例。治疗后1周、3个月、6个月随访时,A、B组NDI评分优良率分别为88.9%和84.4%(P>0.05)、86.1%和81.7%(P>0.05)、75.0%和67.4%(P<0.05);而且,治疗后1周、3个月、6个月两组患者NDI评分均较本组治疗前明显改善(P<0.05)。治疗后1周、3个月、6个月两组患者颈肩痛、上肢痛VAS评分均较本组治疗前明显降低(P<0.05);治疗后1周、3个月及6个月,两组患者在颈肩痛、上肢痛VAS评分方面比较,差异均无统计学意义(P>0.05)。结论经椎间孔选择性神经根阻滞术与传统疗法治疗神经根型颈椎病均能有效缓解症状。两者早期疗效相当,前者并发症较少、中期效果维持较好,后者并发症较多、中期疗效维持情况相对前者较差。Objective To explore the methods and curative effects of the treatments of spondylotic cervical radiculopathy based on the comparison between transforaminal selective nerve root block（ TSNRB） surgery and conservative non-surgical treatment. Methods A retrospective study was performed on 79 cases of patients with spondylotic cervical radiculopathy received in the department of Orthopaedics,No. 202 Hospital of PLA,from January 2011 to December 2013. All 79 cases were into two groups according different treatments,as 36 cases by TSNRB surgery（ Group A）,and 43 cases by conservative non-surgical treatment（ Group B）,respectively. Postoperative follow-up was performed in all cases at 1 week,3 months and 6 months,and neck disability index（ NDI） scores and visual analogue scale（ VAS） scores of the neck and shoulder pain were compared in patients between the two groups,respectively. Results In Group A,the operations spent（ 36. 0 ± 4. 1） minutes,and intraoperative blood loss was（ 13. 6 ± 1. 2） ml,and there were one case suffered from allergic drug rash and 3 cases failed. All 43 patients in Group B received the treatment in hospital for mean 5 days. Postoperative complications occurred in 10 cases,including hyperglycemia in 5 cases,edema of lower extremity in 3 cases,and acute gastritis in 2 cases. Rates of excellent and effective NDI scores in Group A and B at 1 week,3 months and 6 months postoperatively were88. 9% versus 88. 4%（ P 〉 0. 05）,86. 1% versus 83. 7%（ P 〉 0. 05）,and 75. 0% versus 67. 4%（ P 〈 0. 05）,respectively. Meanwhile,postoperative NDI scores in all cases of the two groups were statistical better than the preoperative scores（ P 〈0. 05）. Postoperative VAS scores in all cases of the two groups decreased when compared with the preoperative scores（ P 〈 0. 05）.While,there was no significant difference of the VAS scores between the two groups at 1 week,3 months and 6 months,respectively（ P 〉 0. 05）. Conclusion Both TSNRB surgery and conservative non

关 键 词：神经根型颈椎病 神经根阻滞术 保守治疗 颈部功能评分 视觉模拟评分 

分 类 号：R681[医药卫生—骨科学]