术中椎间盘造影及盘内利多卡因注射对非包含性腰椎间盘突出症的临床意义  

The clinical significance of discography and intradiscal lidocaine injection during interventional treatment of nocontained lumbar disc herniation

作　　者：赵洪增[1] 赵力聪 李杰[1] 刘恒源[1] 王建洲[1] 桑德恩[1] 张海三[1] 傅炎炎[1] 赵利芹[1] 

机构地区：[1]新乡医学院第二附属医院放射介入科,河南新乡453002

出　　处：《颈腰痛杂志》2017年第2期140-143,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：河南省医学科技攻关计划项目(201303111);医院高新人才资助项目部分内容

摘　　要：目的探讨介入治疗术中行椎间盘造影及盘内利多卡因注射对非包含性腰椎间盘突出症的临床意义。方法对非包含性腰椎间盘突出症的影像学筛选病例共143例于介入治疗术前行椎间盘造影,其中130例确诊为非包含性突出,分析其椎间盘造影表现并观察患者的的主观反应;对造影出现疼痛患者,盘内注入利多卡因观察其反应及止痛效果。结果 130例患者椎间盘造影均出现对比剂渗入椎管或进入硬膜外腔,其中95例出现明显疼痛,35例患者仅出现轻微疼痛或腰部轻度不适感。明显疼痛患者经盘内注入利多卡因,5 min内疼痛均明显减轻或消失,对后续介入治疗也有止痛作用。结论术中椎间盘造影简便易行,可进一步确认椎间盘突出类型,对选择介入治疗的方法具有重要意义。对非包含性突出椎间盘造影出现疼痛者,盘内注入利多卡因,可快速取得良好的止痛效果,患者未发生不良反应,且可减轻椎间盘介入治疗中的疼痛。Objective To investigate the clinical value of discography and intradiscal lidocaine injection during interventional in treatment of noncontained lumbar disc herniation （NCLDH）. Methods 130 cases of 143 screening cases of NCLDH were diagnosed, the imaging findings of discography and subjective response to discography of NCLDH were analyzed; intradiscal lidoeaine was injected if the significant pain occurred during discography and the response was observed. Results 130 cases of discography showed contrast leaking into the spinal canal or epidural space, of which, 95 cases were found obvious pain, 35 cases were found mild pain or just lumbar discomfort. Of the 95 cases with obvious pain during discography, all cases were significantly relieved after intradiscal lidocaine injection in 5 minutes, with analgesic effect on interventional operation. Conclusion The discography during interventional treatment was easy to practice and had important clinical value in the differentiation of the types of lumbar disc herniation and selection of proper interventional treatment; intradiscal lidocaine injection was safe and could relieve the pain in discography and interventional treatment.

关 键 词：腰椎间盘突出 非包含性 椎间盘造影 

分 类 号：R681.53[医药卫生—骨科学]