平衡针针麻联合小关节突局部浸润麻醉在腰椎间盘突出症患者经皮椎间孔镜髓核摘除术中的应用效果  

Application effect of acupuncture anesthesia using balance acupuncture combined with facet joint local infiltration anesthesia in percutaneous transforaminal endoscopic discectomy for patients with lumbar disc herniation

作　　者：唐少雄 吕友慧 宋凯 杨利学 TANG Shao-xiong;LYU You-hui;SONG Kai;YANG Li-xue(The First Clinical Medical College,Shaanxi University of Chinese Medicine,Xianyang 712000,China;Department of Spine and Orthopedics,Affiliated Hospital,Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第一临床医学院,咸阳市712000 [2]陕西中医药大学附属医院脊柱骨科,咸阳市712000

出　　处：《广西医学》2020年第18期2340-2343,共4页Guangxi Medical Journal

基　　金：陕西省自然科学基础研究计划(S2018-JC-YB-1870)。

摘　　要：目的观察平衡针针麻联合小关节突局部浸润麻醉在腰椎间盘突出症患者经皮椎间孔镜髓核摘除术(PTED)中的应用效果。方法将89例腰椎间盘突出症患者随机分为观察组44例与对照组45例,两组患者均行PTED术治疗。对照组患者手术时采用小关节突局部浸润麻醉,观察组采用平衡针针麻联合小关节突局部浸润麻醉。分别于经皮穿刺时(T1)、环锯打磨时(T2)、套管置入完成时(T3)及开始夹取椎间盘时(T4),记录患者血压、呼吸频率、心率,术后2 h,采用疼痛视觉模拟量表(VAS)评估患者疼痛情况,并观察两组患者术后1周的疗效。结果观察组的VAS评分低于对照组,手术过程中血压、呼吸频率、心率更平稳(均P<0.05),疗效优于对照组(P<0.05)。结论腰椎间盘突出症患者行PTED手术治疗时,采用平衡针针麻联合小关节突局部浸润麻醉可有效地提高麻醉效果,减轻患者术中疼痛,且疗效好,安全性高。Objective To observe the application effect of acupuncture anesthesia using balance acupuncture combined with facet joint local infiltration anesthesia in percutaneous transforaminal endoscopic discectomy(PTED)for patients with lumbar disc herniation.Methods Eighty-nine patients with lumbar disc herniation were randomly divided into observation group(n=44)and control group(n=45),patients in the two groups underwent PTED.Patients in the control group applied facet joint local infiltration anesthesia to the operation,while the observation group received acupuncture anesthesia using balance acupuncture combined with facet joint local infiltration anesthesia.At the time of percutaneous puncture(T1),the time of trepanation and grinding(T2),the time of complication of trocar implantation(T3)and the beginning of intervertebral disc clamping(T4),patients′blood pressure,respiratory frequency and heart rate were recorded,patients′condition of pain was assessed by the Visual Analogue Scale(VAS)two hours after operation,and efficacy on patients was observed in the two groups one week after operation.Results Compared with the control group,the observation group had lower VAS score,more stable blood pressure,respiratory frequency and heart rate during operation(all P<0.05),achieving superior efficacy(P<0.05).Conclusion In PTED for lumbar disc herniation patients,the use of acupuncture anesthesia using balance acupuncture combined with facet joint local infiltration anesthesia can effectively improve anesthesia effect,reduce patients′pain during operation,and achieve favorable efficacy and high safety.

关 键 词：腰椎间盘突出症 平衡针 小关节突局部浸润麻醉 经皮椎间孔镜髓核摘除术 

分 类 号：R681.533.1[医药卫生—骨科学]