超声联合C臂引导下等离子消融治疗颈源性头痛——一项回顾性研究  

Ultrasound combined with C-arm radiography-guided plasma ablation for cervicogenic headache:a retrospective study

作　　者：杨茂江[1] 席豪 秦泽 刘琼 窦智[5] 徐晓雪[1] 杨立强[5] YANG Maojiang;XI Hao;QIN Ze;LIU Qiong;DOU Zhi;XU Xiaoxue;YANG Liqiang(Pain Department,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China)

机构地区：[1]川北医学院附属医院疼痛科,四川南充637000 [2]郑州大学第五附属医院疼痛科 [3]石家庄市第四人民医院妇产科 [4]重庆市忠县中医院康复科 [5]北京市首都医科大学宣武医院疼痛科

出　　处：《介入放射学杂志》2023年第11期1110-1114,共5页Journal of Interventional Radiology

摘　　要：目的 探讨超声联合C臂引导下等离子消融治疗颈源性头痛的有效性及安全性。方法 本研究回顾性分析收治的颈源性头痛患者41例,所有患者行超声联合C臂引导下等离子消融治疗。记录患者的一般临床数据,通过数字疼痛评分(NRS)比较手术前后的头痛程度,并通过改良的MacNab疗效评估标准评估手术疗效。术后6个月和12个月采用颈椎功能障碍指数(NDI)评估颈椎功能,并记录手术相关并发症。结果 患者术后1周和1、3、6、12个月的头痛程度较术前均显著降低(P<0.05),整体治疗优良率分别100%(41/41)、97.56%(40/41)、92.68%(38/41)、92.68%(38/41)、90.24%(37/41)。术后6个月和12个月,NDI评分较术前明显提高(P<0.05)。术中2例患者出现恶心、呕吐,对症处理后症状改善,所有患者均无大出血或死亡等严重并发症发生。结论 超声联合C臂引导下等离子消融治疗颈源性头痛,能有效缓解患者疼痛,改善颈椎功能,提高生活质量,且安全性好。Objective To investigate the efficacy and safety of ultrasound combined with C-arm radiography-guided plasma ablation in the treatment of cervicogenic headache.Methods This retrospective study included 41 patients with cervicogenic headache,who had received ultrasound combined with C-arm radiography-guided plasma ablation.The general clinical data of patients were collected.Numerical rating scale(NRS) score was used to compare the headache degree before and after treatment,and the modified MacNab efficacy assessment criterion was used to evaluate the therapeutic efficacy.Cervical spine function was assessed by using the neck disability index(NDI) score at 6 and 12 months after treatment,and the procedure-related complications were recorded.Results The postoperative one-week,one-month,3-month,6-month and 12-month headache degrees were significantly lower than the preoperative headache degree(P<0.05),and the overall therapeutic excellent rates were 100%(41/41),97.56%(40/41),92.68%(38/41),92.68%(38/41)and 90.24%(37/41) respectively.The postoperative 6-month and 12-month NDI scores were significantly higher than the preoperative value(P<0.05).During the ablation,2 patients developed nausea and vomiting,which were improved after symptomatic treatment.No severe complications such as massive hemorrhage or death occurred in all patients.Conclusion For the treatment of cervicogenic headache,ultrasound combined with C-arm radiography-guided plasma ablation is clinically safe,it can effectively relieve the pain degree,and improve the cervical spine function as well as the patient's quality of life.

关 键 词：颈源性头痛 微创 影像引导 等离子消融 外周神经 

分 类 号：R681.55[医药卫生—骨科学]