红外热成像在腰椎神经根阻滞治疗腰椎间盘突出症患者临床疗效评估中应用  

The infrared thermal imaging in lumbar nerve root blockage therapy in patients with lumbar disc herniation clinical curative effect evaluation of the application

作　　者：杨小蕾 沈正 朱玉琼 夏静 刘洋 祁敏 YANG Xiao-lei;SHEN Zheng;ZHU Yu-qiong;XIA Jing;LIU Yang;QI Min(Department of Anaesthesiology,Second Hospital Affiliated to Naval Medical University,Shanghai 200070,China;Department of Spine Surgery,Second Hospital Affiliated to Naval Medical University,Shanghai 200070,China;Department of Orthopedics,Dantu District People's Hospital,Zhenjiang 212028,China;Operating Room,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]海军军医大学第二附属医院麻醉科,上海200070 [2]海军军医大学第二附属医院骨科颈椎外科病区,上海200070 [3]丹徒区人民医院骨科,江苏镇江212028 [4]复旦大学附属华东医院手术室,上海200040

出　　处：《临床军医杂志》2023年第8期781-785,共5页Clinical Journal of Medical Officers

基　　金：海军军医大学教学成果立项培育课题(JPY2020B33);国家自然科学基金(82102616)。

摘　　要：目的 探讨红外热成像技术在腰椎退行性疾病患者的临床诊断及治疗中的应用价值。方法 选取自2020年6月至2021年6月海军军医大学第二附属医院日间病房收治的接受腰椎神经根阻滞治疗的53例腰腿疼痛患者为研究对象,其中,有腰痛21例,无腰痛32例;下肢有疼痛症状45例,下肢无疼痛症状8例。纳入患者均常规行腰椎正侧位、过伸过屈位X线影像,三维CT及腰椎MRI评估检查,且在接受腰椎神经根阻滞治疗前后进行红外热成像检查。分别于术前、术后即刻、术后第2天、术后3个月及末次随访时采用疼痛数字评价量表(NRS)评估疼痛程度,采用Oswestry功能障碍指数(ODI)评估功能障碍程度;末次随访时,采用改良MacNab疗效评定标准评估患者总体临床疗效。结果 纳入患者接受神经阻滞治疗后即刻、术后第2天、术后3个月和末次随访时的NRS评分和ODI评分均较术前显著改善,差异有统计学意义(P<0.05);术后各随访时间点的NRS评分和ODI评分与末次随访时比较,差异均无统计学意义(P>0.05)。末次随访时治疗优良率为73.58%(39/53)。术前,有腰痛患者腰部平均温度高于无腰痛患者,差异有统计学意义(P<0.05);下肢有疼痛症状患者疼痛肢体的平均温度高于下肢无疼痛症状患者,差异有统计学意义(P<0.05)。接受神经阻滞治疗后,术后即刻、术后第2天、术后1个月和末次随访时,有腰痛及下肢有疼痛症状患者的平均温度均低于术前,差异均有统计学意义(P<0.05)。在术前和术后各个随访时间点,患者有症状部位的肢体疼痛相关NRS评分与相应部位的红外热成像检测的温度均呈正相关(P<0.05)。结论 红外热成像技术对评估接受腰椎神经阻滞术的腰椎间盘突出症患者的临床疗效具有较高的应用价值。Objective To explore the application value of infrared thermal imaging in the clinical diagnosis and treatment of lumbar degenerative diseases.Methods A total of fifty-three patients with back and leg pain who received lumbar nerve root block in the day ward of the Second Hospital Affiliated to Naval Medical University from June 2020 to June 2021 were selected as subjects.There were 21 cases with lumbago and 32 cases without lumbago,and 45 patients had pain symptom in lower extremity,8 patients had no pain symptom in lower extremity.All included patients underwent routine lumbar anteroposterior and lateral,hyperextension and flexion X-ray imaging,three-dimensional CT and lumbar magnetic resonance imaging evaluation,and infrared thermal imaging before and after receiving lumbar nerve root block treatment.The degree of pain was evaluated by the numerical evaluation scale(NRS)before surgery,immediately after surgery,on the second day after surgery,3 months after surgery and at the last follow-up,respectively.The degree of dysfunction was evaluated by the Oswestry disability index(ODI).At the last follow-up,the modified MacNab efficacy evaluation crite-ria were used to evaluate the overall clinical efficacy of the patients.Results The NRS score and ODI score of the included patients were significantly improved immediately after nerve block treatment,the second day after surgery,the third month after surgery and the last follow-up,with statistical significance(P<0.05).There was no significant difference in NRS score and ODI score at each followup time point compared with the last follow-up(P>0.05).At the last follow-up,the rate of excellent treatment was 73.58%(39/53).Before surgery,the mean waist temperature in patients with lumbago was higher than that in patients without lumbago,and the differ-ence was statistically significant(P<0.05).The mean temperature of pain limbs in patients with lower extremity pain symptoms was higher than that in patients without pain symptoms,and the difference was statistically signific

关 键 词：红外热成像 神经阻滞 腰椎间盘突出症 腰椎退变性疾病 疗效评估 

分 类 号：R681.53[医药卫生—骨科学]