超声引导下银质针疗法联合竖脊肌平面阻滞治疗退变性脊柱侧弯畸形相关性背痛患者的疗效  

Efficacy of ultrasound-guided silver needle therapy combined with erector spinae plane block for the treatment of patients with degenerative scoliosis deformity-related back pain

作　　者：李美睿 张广建 Li Meirui;Zhang Guangjian(Department of Painology,Yanbian University Affiliated Hospital,Yanji City,Jilin Province 133000,China)

机构地区：[1]延边大学附属医院疼痛科,吉林省延吉市133000

出　　处：《中华疼痛学杂志》2022年第4期502-508,共7页Chinese Journal Of Painology

基　　金：吉林省科技发展计划基金(20200201557JC)。

摘　　要：目的观察超声引导下银质针疗法联合竖脊肌平面阻滞治疗退变性脊柱侧弯畸形相关性背痛患者的疗效。方法收集自2019年3月至2021年3月在延边大学附属医院疼痛科收治的退变性脊柱侧弯畸形相关性背痛患者69例,年龄50~70岁,采用随机数字表法将其分为银质针组(ND组)、竖脊肌平面阻滞组(ESPB组)及联合组(CB组),每组23例,ND组在超声引导下行痛侧胸背部银质针治疗,ESPB组在超声引导下行痛侧竖脊肌平面阻滞治疗,CB组综合上述两组治疗方法。所有治疗每周1次,连续4周。分别记录3组患者在治疗前、治疗第1~4次及治疗后4、8、12周时的视觉模拟评分(VAS)、生活质量评分(SF-36)及生活能力评分(ADL),并评估疗效;测量患者治疗前及治疗后4、8、12周时Cobb’s角;观察并发症发生情况。结果与治疗前相比,ESPB组、CB组治疗过程中及治疗后各时点VAS评分均下降(P均<0.05),ND组自治疗第3次后各时点VAS评分下降(P均<0.05);与ND组相比,CB组自治疗第3次后各时点VAS评分较低(P均<0.05),ESPB组在治疗第1、2次后VAS评分较低(P均<0.05);与治疗前相比,3组患者治疗后4、8、12周时SF-36评分及ADL评分均显著升高(P均<0.05),CB组低于ND组、ESPB组(P均<0.05);与治疗前相比,3组患者治疗后4、8、12周时Cobb’s角均减小(P均<0.05),治疗后12周CB组Cobb’s角度差值明显大于ND组、ESPB组(P均<0.05)。治疗后4、12周,CB组较ND组、ESPB组总有效率高(χ^(2)=8.92,P=0.012;χ^(2)=13.85,P=0.001)。3组患者均未见感染、气胸、血肿和局麻药中毒等并发症发生。结论超声引导下银质针疗法和竖脊肌平面阻滞对治疗退变性脊柱侧弯畸形相关性慢性背痛均有效果,两者联合效果更佳,且无明显并发症。Objective To observe the efficacy of ultrasound-guided silver needle therapy combined with erector spinae plane block in the treatment of patients with spinal degenerative scoliosis deformity-related back pain.Methods Sixty-nine patients with chronic back pain related to degenerative scoliosis deformity of both sexes,aged 50-70 years old,from March 2019 to March 2021 in the Yanbian University Affiliated Hospital,were randomly divided into silver needle group(ND group),erector spinae plane block group(ESPB group)and combined group(CB group),23 cases in each group.The patients received ultrasound-guided silver needle treatment on back in the ND group,while received ultrasound-guided ESPB in the ESPB group,and received both methods in the CB group,once a week for 4 consecutive weeks.VAS,SF-36 quality scale of life and ADL scale were recorded before and during the treatment,and 4,8 and 12 weeks after the treatment.Efficacy was evaluated at 4,8 weeks after the treatment,and Cobb's angle was measured before and after the treatment.The complications related to the treatment were observed.Results Compared with pre-treatment,VAS was decreased at each time point during and after the treatment in the ESPB group and CB group(all P<0.05);while VAS was decreased from the 3rd treatment in the ND group(all P<0.05).Compared with ND group,VAS was decreased significantly after the 3rd treatment in the CB group(all P<0.05),and VAS was decreased at the 1st and 2nd treatment in the ESPB group(all P<0.05).At 4,8 and 12 weeks after the treatment,SF-36 and ADL scores were significantly increased compared with pre-treatment in the 3 groups(all P<0.05),and these scores were higher in the CB group than those in the other two groups(all P<0.05).Compared with pre-treatment,the Cobb's angle was decreased at 4,8 and 12 weeks after the treatment in all the groups of patients(all P<0.05);the Cobb's angle difference after the treatment increased significantly at 12 weeks in the CB group compared with the ND group and ESPB group(all P<0.05).The tot

关 键 词：背痛 银质针 竖脊肌平面阻滞 

分 类 号：R681.5[医药卫生—骨科学]