CT引导下颈椎脊髓神经根粘连松解术治疗顽固性呃逆  

CT-guided cervical spinal nerve root adhesion release in treatment of intractable hiccup

作　　者：杨茂江[1] 肖如辉 琼仙 张汉文 张薇[1] 冯林[1] 杨汉丰[1] 徐晓雪[1] YANG Maojiang;XIAO Ruhui;QIONG Xian;ZHANG Hanwen;ZHANG Wei;FENG Lin;YANG Hanfeng;XU Xiaoxue(Department of Pain,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Radiology,the Second Affiliated Hospital of North Sichuan Medical College,Nanchong 637100,China)

机构地区：[1]川北医学院附属医院疼痛科,四川南充637000 [2]川北医学院第二附属医院放射科,四川南充637100

出　　处：《中国介入影像与治疗学》2023年第3期139-142,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：川北医学院附属医院院级科研课题(2020JC037)

摘　　要：目的观察CT引导下经颈椎硬膜外前间隙脊髓神经根粘连松解术治疗顽固性呃逆的效果及其安全性。方法回顾性分析34例接受CT引导下经硬膜外前间隙行脊髓神经根粘连松解术的顽固性呃逆患者,观察术中及术后并发症,记录术后1周及1、3、6个月呃逆改善情况;分别以改良MacNab疗效评定标准(优、良、中、差)及医疗结局研究量表(MOS SF)-36评估疗效及术后3和6个月患者生活质量改善程度。结果34例均完成手术;术中3例出现高血压,2例一过性心率明显下降,均经对症处理后缓解。术后21例诉术区皮下肿胀感,均于3天内自行缓解。未见感染、出血等并发症。术后1周及1、3、6个月疗效优良率分别为82.35%(28/34)、88.24%(30/34)、97.06%(33/34)及97.06%(33/34)。术后3及6个月,患者MOS SF-36评分均逐渐升高(P均<0.05)。结论CT引导下经颈椎硬膜外前间隙行脊髓神经根粘连松解术治疗顽固性呃逆安全、有效。Objective To observe the efficacy and safety of CT-guided spinal cord nerve root adhesion release through the anterior cervical epidural space for treating intractable hiccup.Methods Data of 34 patients with intractable hiccup who underwent CT-guided spinal cord nerve root adhesion release through the anterior epidural space were retrospectively analyzed.The intraoperative and postoperative complications were observed,the improvement of hiccup were analyzed 1 week,1,3 and 6 months after treatment.The therapeutic efficacies were evaluated using modified MacNab efficacy evaluation criteria(excellent,good,medium and poor),and the improvement of life quality 3 and 6 months after treatment were assessed using medical outcomes study-short from(MOS SF)-36 scale.Results All 34 patients completed the treatment successfully.Hypertension occurred in 3 cases,while transient heart rate drop occurred in 2 cases during operations,and then relieved after symptomatic treatments.Subcutaneous swelling in the operative area was observed in 21 cases after release,which relieved within 3 days.No complication such as infection and bleeding happened.One week,1,3 and 6 months after release,the excellent and good rate of surgical efficacy was 82.35%(28/34),88.24%(30/34),97.06%(33/34)and 97.06%(33/34),respectively.Three and 6 months after release,MOS SF-36 scores of patients increased gradually(both P<0.05).Conclusion CT-guided spinal cord nerve root adhesion release through the anterior cervical epidural space was safe and effective for treating intractable hiccup.

关 键 词：呃逆 神经松解术 脊髓 介入治疗 影像引导 顽固性呃逆 

分 类 号：R256.31[医药卫生—中医内科学] R815[医药卫生—中医学]