超声引导与C型臂引导下颈脊神经脉冲射频治疗颈椎间盘突出症所致颈肩及上肢根性痛疗效及优势的比较  

Comparison of the ultrasound guided or the C-arm guided pulsed radiofrequency in the treatment of patients with neck-shoulder pain and upper limb radicular neuralgia caused by cervical disc herniation

作　　者：林楚妍 刘少颜[1] 宫庆娟[1] 万丽[1] Lin Chuyan;Liu Shaoyan;Gong Qingjuan;Wan Li(Department of Pain Management,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou City,Guangdong Province 510260,China)

机构地区：[1]广州医科大学附属第二医院疼痛科,510260

出　　处：《实用疼痛学杂志》2019年第4期253-258,共6页Pain Clinic Journal

摘　　要：目的观察超声引导与C型臂引导下颈脊神经脉冲射频治疗颈椎间盘突出症所致颈肩及上肢根性痛的疗效及优势比较。方法选择2017年12月至2018年6月在广州医科大学附属第二医院疼痛科诊治的颈椎间盘突出症导致的颈肩痛及上肢根性痛患者42例,性别不限,年龄>18岁,按照随机数字表法随机分为超声引导组(UG组,n=22)和C型臂引导组(CG组,n=20)。两组分别在超声或C型臂引导下精确定位后行颈脊神经脉冲射频治疗,评估两组操作时间,患者术前及术后数字分级评分(NRS),术后3、6个月时的疗效及并发症。结果UG组与CG组操作时间分别为(16.4±2.5)min、(29.4±7.2)min,CG组操作时间更长,差异具有统计学意义(P<0.05);UG组与CG组术后NRS评分分别为(1.4±0.2)、(1.5±0.2)均较术前(6.7±1.2)、(6.0±1.3)明显降低,差异均有统计学意义(P均<0.001),且UG组略优于CG组(P<0.05);术后3、6个月时疼痛疗效两组差异均无统计学意义(P均>0.05)。两组患者术后均未见严重并发症,CG组有1例患者术后出现短暂右上臂无力,4d后恢复。结论超声引导与C型臂引导下行颈脊神经脉冲射频治疗均能有效缓解颈椎间盘突出症所致的颈肩及上肢根性痛,两法疗效相当,但超声引导具有操作时间短,可实时显示,能避免医患射线暴露的优势。Objective To compare the efficacy and advantage of pulsed radiofrequency(PRF) guided by ultrasound or C-arm in the treatment of patients with neck-shoulder pain and upper limb radicular neuralgia caused by cervical disc herniation. Methods Forty-two patients with neck-shoulder pain and upper limb radicular neuralgia, male or female, above 18 years old, were randomly divided into ultrasound guided group (group UG, n=22) and C-arm guided group (group CG, n=20) in the Department of Pain Management of the Second Affiliated Hospital of Guangzhou Medical University from December 2017 to June 2018, undergoing pulsed radiofrequency. The patients were treated with pulsed radiofrequency under the guidance of ultrasound or C-arm in the two groups respectively. The procedure time, the numerical rating scale (NRS) before and after the treatment, the effect at the 3rd and 6th month after the treatment, the occurrences of complications were all evaluated in the two groups. Results The procedure time was (16.4±2.5) min and (29.4±7.2) min in group UG and group CU respectively, and the time in group CG was longer than that in group UG (P<0.05). The NRS was significantly lower in group UG (1.4±0.2) and group CG (1.5±0.2) after the treatment than that before the treatment[(6.7±1.2),(6.0±1.3)](all P<0.05), and the pain relief rate was better in group CG than that in the group UG, but there was no significant difference (all P>0.05). The effect was similar in both groups at the 3rd and 6th month (all P>0.05). Serious complications were not shown in both groups, and there was only one patient showed transient upper limb weakness and recovered 4 days later. Conclusion Both ultrasound guided and C-arm guided PRF of the cervical spinal nerve can effectively relieve the neck-shoulder pain and upper limb radicular neuralgia in the treatment of patients with cervical disc herniation. The effect was similar with the two methods, but the ultrasound guidance has advantage in procedure time, real time display and avoiding X-ray exposure fo

关 键 词：超声检查 体层摄影术  X线 导管消融术 颈椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]