DSA引导下刃针松解治疗腰椎压缩骨折球囊扩张椎体后凸成形术术后残余腰背痛  

DSA-Guided Indwelling Needle Release for Residual Low Back Pain after Lumbar Compression Fracture Balloon Dilated Kyphoplasty

作　　者：宫云昭[1] 刘春雷 王世轩[1] 李可大[3] 齐鹏坤[4] GONG Yun-zhao;LIU Chun-lei;WANG Shi-xuan;LI Ke-da;QI Peng-kun(Department of Orthopaedics,The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110034;The Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000;Liaoning University of Traditional Chinese Medicine,Shenyangm Liaoning 110032;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110032)

机构地区：[1]辽宁中医药大学附属二院,辽宁沈阳110034 [2]承德医学院附属医院,河北承德067000 [3]辽宁中医药大学,辽宁沈阳110032 [4]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《世界中西医结合杂志》2021年第1期140-143,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：第六批全国老中医药专家学术经验继承工作[国中医药人教发(2017)29号]。

摘　　要：目的观察数字减影血管造影技术(Digital Subtraction Angiography,DSA)引导下刃针松解治疗腰椎压缩骨折患者球囊扩张椎体后凸成形术(percutanouskyphoplasty,PKP)术后残余腰背痛的临床疗效。方法选取2018年5月—2019年12月期间在辽宁中医药大学附属二院骨三科收治的PKP术后两个月仍残余腰背痛的患者60例,按患者的入院顺序编号,随机分成两组,每组30例。对照组患者予传统刃针治疗;治疗组患者予DSA引导下刃针松解治疗。两组患者治疗两周后观察其临床疗效,并比较两组患者治疗前后的疼痛视觉模拟(visual analogue scale,VAS)评分,日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)评分,腰椎Oswetry功能障碍指数(The Oswetry Disability Index,ODI)评分变化情况及不良反应发生情况。结果两组患者治疗后VAS、ODI评分均降低,JOA评分均升高与治疗前比较,差异有统计学意义(P<0.05)。且治疗组治疗后VAS、ODI评分降低水平、JOA评分升高水平均优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后治疗组临床总有效率为96.7%(29/30),对照组临床总有效率为80.0%(24/30),两组比较差异有统计学意义(P<0.05)。治疗期间治疗组患者无不良反应发生,对照组不良反应发生率16.67%(5/30),两组比较差异有统计学意义(P<0.05)。结论DSA引导下刃针松解治疗腰椎压缩骨折PKP术后患者残余腰背痛的临床疗效明显,可快速缓解腰背部疼痛,改善腰椎功能及相关症状,提高患者的生活质量。Objective To observe the clinical effect of digital subtraction angiography(Digital Subtraction Angiography,DSA)guided blade needle lysis for the treatment of residual low back pain after percutanous kyphoplasty(PKP)in patients with lumbar compression fractures.Methods From May 2018 to December 2019,60 patients with residual back pain after PKP who were admitted to the Third Department of Orthopedics,Second Hospital of Liaoning University of Traditional Chinese Medicine from May 2018 to December 2019 were selected and randomized according to their admission order.Divided into two groups with 30 cases in each group.Patients in the control group were treated with traditional blade acupuncture;patients in the treatment group were treated with blade acupuncture under DSA guidance.Observe the clinical efficacy of the two groups of patients after two weeks of treatment,and compare the pain visual analogue scale(VAS)scores,Japanese Orthopaedic Association Scores(JOA)scores,and lumbar Oswetry before and after treatment.The dysfunction index(The Oswetry Disability Index,ODI)score changes and adverse reactions.Results The VAS and ODI scores of the two groups of patients decreased after treatment,and the JOA scores increased compared with those before treatment.The difference was statistically significant(P<0.05).After treatment,the decrease in VAS and ODI scores and the increase in JOA score in the treatment group were better than those in the control group.There was a statistically significant difference between the two groups(P<0.05).After treatment,the total clinical effective rate of the treatment group was96.7%(29/30),and the total clinical effective rate of the control group was 80.0%(24/30).The difference between the two groups was statistically significant(P<0.05).During the treatment period,there was no adverse reaction in the treatment group,and the adverse reaction rate in the control group was 16.67%(5/30).The difference between the two groups was statistically significant(P<0.05).Conclusion DSA-guided inferior

关 键 词：刃针疗法 数字减影技术 腰椎压缩骨折 

分 类 号：R683.2[医药卫生—骨科学]