局部注射曲安奈德对椎间孔镜下髓核摘除术后神经根水肿的预防作用  

Preventive Effect of Local Injection of Triamcinolone Acetonide on Nerve Root Edema after Microendoscopic Discectomy of Nucleus Pulposus

作　　者：魏星 李波 冯世龙 WEI Xing;LI Bo;FENG Shilong(Chongqing Three Gorges Central Hospital, Chongqing 404000, China)

机构地区：[1]重庆市三峡中心医院骨科脊柱病区

出　　处：《河北医学》2020年第3期425-429,共5页Hebei Medicine

基　　金：重庆市科技计划项目，(编号:2014012546)

摘　　要：目的:研究局部注射曲安奈德对椎间孔镜下髓核摘除术后神经根水肿的预防作用。方法:80例腰椎间盘突出症患者依据简单随机法分为对照组(n=38)和观察组(n=42),均接受椎间孔镜下髓核摘除术治疗,观察组在受压神经根鞘内注射40mg曲安奈德,对照组不做此处理。比较两组术后神经根水肿发生情况,临床疗效,治疗前后疼痛介质,视觉模拟疼痛评分(VAS),Oswestry功能障碍指数问卷表(ODI)评分,日本骨科协会评估治疗分数(JOA)评分,和安全性情况。结果:术后,观察组神经根水肿发生率低于对照组(P<0.05)。术前,两组疼痛介质水平、VAS、ODI及JOA评分比较差异无统计学意义(P>0.05);术后3d及7d,两组疼痛介质水平、VAS、ODI评分均下降,观察组低于对照组,JOA评分均上升,观察组高于对照组,两组疼痛介质水平、VAS、ODI及JOA评分在不同时间、不同治疗方法上比较有统计学意义(P<0.05)。术后,两组安全性指标较术前无明显改变(P>0.05)。结论:局部注射曲安奈德对椎间孔镜下髓核摘除术后神经根水肿有一定预防作用,可减轻疼痛程度,提高临床疗效,安全可靠。Objective:To study the preventive effect of local injection of triamcinolone acetonide on nerve root edema after microendoscopic discectomy of nucleus pulposus.Methods:80 patients with lumbar disc herniation were divided into control group(n=38)and observation group(n=42)according to simple random method.All patients were treated with nucleus pulposus extraction under the intervertebral foramen microscope.40 mg triamcinolone acetonide was injected into the sheath of compressed nerve root in the observation group,but not in the control group.The occurrence,clinical effect,pain media,VAS,ODI,JOA and safety of the two groups were compared.Results:The incidence of nerve root edema in the observation group was lower than that in the control group(P<0.05).Before operation,there was no significant difference in the levels of pain media,VAS,ODI and JOA scores between the two groups(P>0.05);three days and seven days after operation,the levels of pain media,vas and ODI scores in the two groups decreased,the observation group was lower than the control group,JOA scores increased,the observation group was higher than the control group,the levels of pain media,VAS,ODI and JOA scores in the two groups were statistically significant at different times and different treatment methods Significance(P<0.05).After operation,the safety indexes of the two groups had no significant change(P>0.05).Conclusion:Local injection of triamcinolone acetonide has a certain preventive effect on the edema of nerve root after the nucleus pulposus removal under the intervertebral foramen,which can reduce the degree of pain,improve the clinical effect,and is safe and reliable.

关 键 词：椎间孔镜下髓核摘除术 曲安奈德 神经根水肿 预防作用 

分 类 号：R68[医药卫生—骨科学]