超声引导下脊神经后支射频联合针刀治疗腰椎关节源性腰痛的临床研究  

Clinical study of radiofrequency thermocoagulation combined with needle knife on posterior ramus of lumbar spinal nerve under ultrasound-guidance in the treatment for lumbar facet-related lumbago

作　　者：田文华[1] 高嵩[2] 邓致远 雷敏 魏常 赵亮[1] 丁一娟 唐俊[1] Tian Wenhua;Gao Song;Deng Zhiyuan;Lei Min;Wei Chang;Zhao Liang;Ding Yijuan;Tang Jun(Department of Pain Medicine,Wuhan Hospital of Traditional Chinese Medicine,Wuhan City,Hubei Province 430012,China;Department of Pain Medicine,Wuhan Hankou Hospital,Wuhan City,Hubei Province 430014,China)

机构地区：[1]武汉市中医医院疼痛科,430012 [2]武汉市汉口医院疼痛科,430014

出　　处：《中华疼痛学杂志》2020年第4期286-290,共5页Chinese Journal Of Painology

基　　金：武汉市卫生和计划生育委员会项目(WX18C31)。

摘　　要：目的比较超声引导下腰椎脊神经后支射频与腰椎脊神经后支射频联合针刀治疗关节源性慢性腰痛患者的临床疗效。方法收集2018年8月至2019年8月在武汉市中医医院疼痛科确诊为关节源性慢性腰痛患者72例,年龄49~70岁,男42例,女30例,按照治疗方法分为射频治疗组(RF组,n=36)与射频联合针刀治疗组(RFA组,n=36)。两组患者均在超声引导下行腰椎脊神经后支治疗,RF组单纯行射频治疗,RFA组采用射频联合针刀治疗。记录两组患者治疗前、治疗后1、3、7 d、1及3个月时VAS评分;对两组患者治疗后6个月时疗效进行评估比较。结果两组患者性别、年龄、病程和疼痛部位等一般资料比较,差异均无统计学意义(P均>0.05)。与治疗前比较,RF组和RFA组患者术后各时点VAS评分均降低,差异有统计学意义(P均<0.05)。与RF组比较,RFA组患者术后1、3个月VAS评分均较低,差异有统计学意义[(1.8±1.5)分比(2.6±1.4)分,(1.6±1.1)分比(2.8±1.2)分,P均<0.05]。治疗后6个月时RFA组优良率88.9%(32/36例)明显高于RF组63.9%(23/36例),差异有统计学意义(P<0.05)。结论超声引导下腰椎脊神经后支射频联合针刀治疗腰椎关节源性腰痛,患者疼痛改善明显,且安全有效。Objective To compare the clinical effect of radiofrequency thermocoagulation and radiofrequency thermocoagulation combined with needle knife on posterior ramus of lumbar spinal nerve in the treatment of lumbar facet-related lumbago under ultrasound-guided.Methods Seventy-two patients with lumbar facet-related lumbago,aged 49-70 years old,42 male,30 female,admitted to the Pain Department of Wuhan Hospital of Traditional Chinese Medicine were randomly divided into the radiofrequency group(RF group,n=36)and radiofrequency combined with needle knife group(RFA group,n=36)according to the treatment from August 2018 to August 2019.The patients were treated with radiofrequency thermocoagulation on posterior ramus of lumbar spinal nerve under ultrasound-guided in RF group,while in RFA group was treated with radiofrequency thermocoagulation combined with needle knife on posterior ramus of lumbar spinal nerve under ultrasound-guided.VAS was recorded for patients at 1 day,3 days,7 days,1 month and 3 months before and after the treatment.The curative effects were compared between the two groups at 6 months after the treatment.Results There was no significant difference in gender,age,course of disease and pain location between the two groups(all P>0.05).Compared with pre-treatment,VAS was decreased at each time point after the treatment in two groups(all P<0.05).VAS was significantly decreased at 1,3 months after the treatment in RFA group than those in RF group respectively[(1.8±1.5)vs.(2.6±1.4),(1.6±1.1)vs.(2.8±1.2),all P<0.05].At 6 months after the treatment,the excellent rate of patients in group RAF was 88.9%(32/36 cases),significantly higher than that in group RF 63.9%(23/36 cases),with significant difference(P<0.05).Conclusion Painful symptom is significantly and safely improved by the treatment of radiofrequency thermocoagulation combined with needle knife on posterior ramus of lumbar spinal nerve under ultrasound-guided in the patients with lumbar facet-related lumbago.

关 键 词：射频 针刀 腰椎关节源性腰痛 脊神经 超声引导下 

分 类 号：R445.1[医药卫生—影像医学与核医学] R687.4[医药卫生—诊断学]