超声引导下选择性颈神经根阻滞联合中频电疗治疗神经根型颈椎病  

Ultrasound-guided selective cervical nerve root block combined with intermediate frequency electrotherapy in treatment of cervical spondylotic radiculopathy

作　　者：郭辉[1] 张志军[1] 杨立强[2] GUO Hui;ZHANG Zhijun;YANG Liqiang(Department of Anesthesiology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China;Department of Pain, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]中国中医科学院望京医院麻醉科,北京100102 [2]首都医科大学宣武医院疼痛科,北京100053

出　　处：《中国介入影像与治疗学》2022年第4期193-196,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：北京市科学技术委员会首都临床诊疗技术研究及示范应用专项优势学科培育项目(Z191100006619044);北京市医院管理中心扬帆计划(重点扶持专业)(ZYLX202134)。

摘　　要：目的观察超声引导下选择性颈神经根阻滞(SCNRB)联合中频电疗治疗神经根型颈椎病(CSR)的效果。方法纳入126例CSR患者,将其随机分为中频电疗组、SCNRB组及联合组,每组42例。比较3组治疗前及以对应方案治疗3周后颈椎功能[颈椎功能障碍指数(NDI)量表评分]、疼痛因子水平[前列腺素E2(PGE2)、P物质(SP)]的差异;记录治疗期间阻滞部位出现出血、感染或电极灼伤等并发症,并随访观察治疗1年后CSR复发情况。结果治疗前,3组CSR NDI量表评分、PGE2及SP水平差异均无统计学意义(P均>0.05);治疗3周后,中频电疗组、SCNRB组及联合组NDI量表评分、PGE2及SP水平均低于治疗前(P均<0.05),且联合组低于中频电疗组及SCNRB组(P均<0.05),SCNRB组低于中频电疗组(P均<0.05)。随访1年,3组CSR复发率差异无统计学意义(χ^(2)=2.82,P=0.24)。结论SCNRB联合中频电疗治疗可改善CSR患者颈椎功能,降低疼痛因子水平,且安全性好,复发率低。Objective To observe the effect of ultrasound-guided selective cervical nerve root block(SCNRB)combining with intermediate frequency electrotherapy for treatment of cervical spondylotic radiculopathy(CSR).Methods Totally 126 patients with CSR were randomly divided into intermediate frequency electrotherapy group,SCNRB group and combination group(each n=42).The indexes of cervical function(scores of neck disability index[NDI]scale)and levels of pain factors(prostaglandin E2[PGE2],substance P[SP])were compared among 3 groups before and 3 weeks after treatment of corresponding scheme.Complications such as bleeding,infection or electrode burn at the block site during treatment were recorded,and the patients were followed up for one year to observe the recurrence of CSR after treatment.Results Before treatment,there was no significant difference of NDI scale scores nor PGE2 and SP levels of CSR patients among 3 groups(all P>0.05).Three weeks after treatment,the scores of NDI scale,PGE2 and SP in intermediate frequency electrotherapy group,SCNRB group and combined group were lower than those before treatment(all P<0.05),in combination group was lower than those in intermediate frequency electrotherapy group and SCNRB group(all P<0.05),and in SCNRB group was lower than those in intermediate frequency electrotherapy group(all P<0.05).After 1-year follow-up,there was no significant difference in the recurrence rate of CSR among the three groups(χ^(2)=2.82,P=0.24).Conclusion SCNRB combining with intermediate frequency electrotherapy could improve the function of cervical spine and reduce pain factor levels of CSR patients,which was safety and with low recurrence rate.

关 键 词：神经根型颈椎病 神经传导阻滞 超声检查 电刺激治疗 

分 类 号：R681.55[医药卫生—骨科学] R445.1[医药卫生—外科学]