颈椎硬膜外阻滞治疗以坐骨神经痛为表现的颈腰综合征患者的疗效  

Efficacy of cervical epidural block for patients with cervical-lumbar syndrome presenting sciatica as main symptom

作　　者：刘德宝 陈宁 陈晓光 Liu Debao;Chen Ning;Chen Xiaoguang(Department of Pain Medicine,First People's Hospital of Zhengzhou City,Zhengzhou City,Henan Province 450000,China)

机构地区：[1]郑州市第一人民医院疼痛科,郑州市450000

出　　处：《中华疼痛学杂志》2022年第6期768-771,共4页Chinese Journal Of Painology

摘　　要：目的:评价颈椎硬膜外阻滞治疗以坐骨神经痛为表现的颈腰综合征患者的临床效果。方法:收集2018年1月至2020年10月郑州市第一人民医院疼痛科收治的以坐骨神经痛为表现的颈腰综合征患者30例,年龄、性别不限。在CT引导下行颈椎硬膜外注射,配方为地塞米松棕榈酸酯4 mg+腺苷钴胺3 mg+2%利多卡因1 ml,以生理盐水8 ml稀释至10 ml。记录治疗前及治疗后1周、6个月时视觉模拟评分(VAS)、日本骨科学会(JOA)评分、Oswestry功能障碍指数(ODI)。结果:最终26例患者完成治疗及随访,与治疗前比较,治疗后1周和6个月时VAS评分、ODI评分均降低,JOA评分升高,差异均有统计学意义( P均<0.05);与治疗后1周时比较,治疗后6个月时VAS评分、ODI评分均降低,JOA评分升高,差异均有统计学意义( P均<0.05)。 结论:颈椎硬膜外阻滞治疗可改善以坐骨神经痛为表现的颈腰综合征患者功能障碍及坐骨神经疼痛症状。Objective To investigate the clinical efficacy of cervical epidural block in the treatment of patients with cervical-lumbar syndrome featured as sciatica.Methods From January 2018 to October 2020,30 patients with cervical-lumbar syndrome presenting the main symptom as sciatica were enrolled in the Department of Pain Medicine,First People's Hospital of Zhengzhou City,regardless of age and gender.The mixture of dexamethasone palmitate 4 mg+cobamamide adenosine 3 mg+2% lidocaine 1 ml and sodium chloride 8 ml was injected into cervical epidural space under the guidance of CT.VAS,JOA and ODI were recorded before the treatment,1 week and 6 months after the treatment.Results There were 26 cases finished the treatment course and followed-up.Compared with pre-treatment,VAS and ODI were decreased at 1 week and 6 months after the treatment,while JOA was increased(all P<0.05).Compared with 1 week after the treatment,VAS and ODI were decreased at 6 months after the treatment,while JOA was increased(all P<0.05).Conclusion Cervical epidural block can ameliorate the dysfunction and symptoms of sciatica in patients with cervical-lumbar syndrome presenting as sciatica.

关 键 词：颈腰综合征 坐骨神经痛 串联型脊椎狭窄 注射 硬膜外 

分 类 号：R614[医药卫生—麻醉学]