DSA引导下腰椎脊神经后支射频联合针刀治疗关节源性腰痛的疗效观察  

Observation on the curative effect of DSA-guided radiofrequency for posterior ramus of lumbar spinal nerve combined with needle knife in treatment of lumbar facet related lumbago

作　　者：袁汉武 田文华[2] 邓致远 雷敏 魏常 赵亮[2] 丁一娟 唐俊[2] YUAN Han-wu;TIAN Wen-hua;DENG Zhi-yuan(Department of Pain Medicine, Hannan District Hospital of Traditional Chinese Medicine in Wuhan City, Hubei 430090, China)

机构地区：[1]武汉市汉南区中医医院疼痛科,湖北430090 [2]武汉市中医医院疼痛科,湖北430050

出　　处：《中国临床新医学》2020年第10期1003-1007,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：武汉市卫健委科研项目(编号:WX18C31)。

摘　　要：目的观察数字减影血管造影技术(DSA)引导下腰椎脊神经后支射频联合针刀治疗关节源性腰痛的疗效。方法选择2018-08~2019-08于该院接受治疗的关节源性腰痛患者72例,采用随机数字表法将其分为对照组和观察组,每组36例。对照组采用DSA引导下腰椎脊神经后支射频治疗,观察组采用DSA引导下腰椎脊神经后支射频联合针刀治疗。比较两组术前与术后第1天、术后第3天、术后第7天、术后1个月、术后3个月时视觉模拟量表(VAS)评分和功能障碍指数(ODI)评分。比较两组疗效及术后并发症发生情况。结果术后两组VAS评分和ODI评分均呈下降趋势,两组术后各时点VAS评分和ODI评分均较术前低,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05)。在术前、术后第1天、术后第3天和术后第7天,两组VAS评分和ODI评分差异无统计学意义(P>0.05);术后1个月和术后3个月,观察组VAS评分和ODI评分均低于对照组,差异有统计学意义(P<0.05)。在治疗6个月后,观察组优良率为88.89%,对照组为63.89%,两组比较差异有统计学意义(P<0.05)。结论DSA引导下腰椎脊神经后支射频联合针刀治疗关节源性腰痛效果显著,患者术后活动功能恢复良好,无明显不良反应的发生,值得临床推荐。Objective To observe the curative effect of the digital subtraction angiography(DSA)-guided radiofrequency for posterior ramus of lumbar spinal nerve combined with needle knife in treatment of lumbar facet related lumbago.Methods Seventy-two patients with lumbar facet related lumbago who received treatment in our hospital from August 2018 to August 2019 were selected and divided into control group and observation group by the random number table method,with 36 cases in each group.The control group was treated with DSA-guided radiofrequency for posterior ramus of lumbar spinal nerve,and the observation group received DSA-guided radiofrequency for posterior ramus of lumbar spinal nerve combined with needle-knife therapy.Visual Analogue Scale(VAS)scores and Oswestry Disability Index(ODI)scores were compared between the two groups before and 1 day,3 days,7 days,1 month,3 months after operation.The curative effect and the incidence of postoperative complications were compared between the two groups.Results The postoperative VAS scores and ODI scores showed a downward trend in both groups.The VAS scores and the ODI scores in the two groups at each time point after operation were lower than those before operation,and the decrease ranges of the observation group were significantly greater than those of the control group(P<0.05).There were no significant differences in the VAS scores and the ODI scores between the two groups before operation,and 1 day,3 days and 7 days after operation(P>0.05).The VAS scores and the ODI scores in the observation group were lower than those in the control group 1 and 3 months after operation,and the differences were statistically significant(P<0.05).After 6 months of treatment,the excellent and good rate of the observation group was 88.89%,and that of the control group was 63.89%,with a significant difference between the two groups(P<0.05).Conclusion DSA-guided radiofrequency for posterior ramus of lumbar spinal nerve combined with needle knife has a significant effect on treatment of lumba

关 键 词：关节源性腰痛 腰椎脊神经后支 射频 针刀 

分 类 号：R242[医药卫生—中医临床基础]