颈椎间孔射频复合激素注射治疗老年神经根型颈椎病临床观察  

Clinical observation of radiofrequency thermocoagulation combined steroid injection in treatment of the aged cervical spondylotic radiculopathy

作　　者：张云 陈辉 季锋 李秀娟 许华 熊源长 Zhang Yun;Chen Hui;Ji Feng;Li Xiujuan;Xu Hua;Xiong Yuanchang(Pain Center of Anesthesiology,Changhai Hospital,Naval Military Medical University,Shanghai 200433,China（Zhang Y,Chen H,Ji F,Li X J,Xu H,Xiong YC)

机构地区：[1]海军军医大学附属长海医院麻醉学部疼痛中心,上海200433

出　　处：《国际麻醉学与复苏杂志》2018年第9期823-826,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的评价超声引导颈椎间孔外口射频热凝复合消炎镇痛液注射治疗老年神经根型颈椎病（cervical spondylotic radiculopathy。CSR）的安全性和有效性。方法采用随机数字表法将40例老年CSR患者分为两组（每组20例）：试验组（T组）、对照组（C组）。两组均在超声引导下行病变颈椎间孔外口靶点穿刺。穿刺到位后，T组行射频热凝（55℃60s，60℃120s，65℃60s）＋消炎镇痛液（配方：0．25％利多卡因＋地塞米松10mg＋碘海醇共4ml）注射治疗，注射后即刻行颈段CT扫描，观察药液分布范围；C组单纯行消炎镇痛液（配方：0．25％利多卡因＋地塞米松10mg＋无菌生理盐水共4ml）注射治疗。记录治疗前、治疗结束后1个月以及治疗结束后6个月患者VAS评分，用改良Macnab标准评价治疗结束后6个月临床疗效以及评价两组患者对治疗的满意度。观察术中有无血管、神经损伤，术后有无麻木、神经功能障碍的发生。结果所有患者均成功完成治疗，无患者出现血管、神经损伤。与治疗前比较，两组患者治疗后1个月、6个月VAS评分明显降低（P〈0．05），其中T组治疗结束后1个月、6个月疼痛VAS评分降低更为明显，两组数据比较差异有统计学意义（P〈0．05）.T组临床疗效优良率85％，C组优良率45％，两组数据比较差异有统计学意义（P〈0．05）。结论超声引导颈椎间孔外口射频热凝联合激素注射治疗老年CSR安全、有效。Objective In this study, ultrasound and CT-guided radiofrequency ablation combined with injection through the cervical intervertebral foramen in the treatment of geriatric patients with cervical spondylotic radiculopathy （CSR） and just injection in the treatment of geriatric patients with CSR,compared the clinical effects of two different treatments on senile patients with CSR. Methods Forty geriatric patients with CSR were randomly divided into two groups using a random number table （n=20）： The test group （group T）, The control group （group C）. The course of treatment are under ultrasound for body surface location. Patients in Group T were treated with radiofrequency thermocoagulation （55 ℃ 60 s, 60 ℃ 120 s, 65 ℃ 60 s） ＋injection antiphlogistic and analgesic （prescription： 0.25% lidocaine ＋ 10 mg dexamethasone ＋ iohexol,a total of 4 ml ）. Patients in Group C were only treated with anti-inflammatory analgesic （prescription： 0.25% lidocaine ＋ 10 mg dexamethasone ＋ sterile saline,a total of 4 ml）. The effectiveness evaluation mainly used the VAS score before treatment, 1 month after the treatment and 6 months after treatment to evaluate the clinical efficacy at 6 months after the treatment and the patients＇ satisfaction. Results All patients were treated successfully. During the process of treatment and after treatment, no patient showed vascular and nerve injury. Also, no patient had numbness and neurological dysfunction after operation. Pain VAS scores of group T and group C were lower than the values of before, 1 month and 6 month after the treatment （P〈0.05）. Among them, pain VAS score of group T decreased more significantly. The excellent rate of group T was 85% but the rate of group C was only 45%. There was significant difference between two groups （P〈0.05）. Conclusions Ultrasound and CT-guided radiofrequency thermocoagulation combined with injection through the cervical intervertebral foramen in the treatment of senile patients with CSR is a si

关 键 词：超声 射频 老年人 神经根型颈椎病 

分 类 号：R681.55[医药卫生—骨科学]