射频消融技术治疗腰椎小关节和骶髂关节疼痛的疗效分析:系统回顾和荟萃分析  

Efficacy of radiofrequency ablation in treatment of lumbar facet joint andsacroiliac joint pain:a systematic review and Meta-analysis

作　　者：肖雷 张晨昱 杨勇明 罗军[1] XIAO Lei;ZHANG Chen-yu;YANG Yong-ming;LUO Jun(Department of Rehabilitation Medicine,Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330000,China)

机构地区：[1]南昌大学第二附属医院康复医学科,江西南昌330000

出　　处：《颈腰痛杂志》2023年第6期921-925,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的系统分析射频消融技术治疗腰椎小关节(lumbar facet joint,LFJ)和骶髂关节(sacroiliac joint,SIJ)疼痛的疗效。方法通过计算机检索万方、维普、知网、PuMed/MEDLINE、Embase、Cochrane Central Register of Controlled Trials(CCRCT)、Cochrane Database of Systematic Reviews(CDSR)等数据库,检索射频消融治疗SIJ/LFJ的随机对照研究,进行文献质量评价后,采用Revman 5.3软件进行定量合成分析。结果共纳入9篇随机对照文献和560例患者。Meta分析显示,射频消融可提高SIJ/LFJ患者治疗的临床有效率(OR=16.41,95%CI=2.18~123.28,P=0.007)和优良率(OR=11.94,95%CI=5.02~28.36,P<0.001);射频消融可降低SIJ/LFJ患者的治疗后1周时VAS/NRS评分(WMD=-0.50,95%CI=-0.61~-0.39,P<0.001)、治疗后3个月时VAS/NRS评分(WMD=-1.37,95%CI=-1.82~-0.91,P<0.001)、治疗后6个月时VAS/NRS评分(WMD=-2.25,95%CI=-3.75~-0.75,P=0.003)、治疗后1个月时ODI指数(WMD=-14.86,95%CI=-28.73~-0.99,P=0.04)、治疗后3个月时ODI指数(WMD=-6.00,95%CI=-10.74~-6.53,P=0.01);射频消融对治疗后1 d时VAS/NRS评分(WMD=-0.06,95%CI=-0.35~0.23,P=0.67)、治疗后1个月时VAS/NRS评分(WMD=-0.85,95%CI=-1.91~0.21,P=0.12)和不良反应(OR=0.25,95%CI=0.05~1.29,P=0.10)无显著影响。结论射频消融治疗SIJ/LFJ安全有效。Objective To systematically analyze the efficacy of radiofrequency ablation in the treatment of patients with lumbar facet joint(LFJ)and sacroiliac joint(SIJ)pain.Methods Wanfang,VIP,HowNet,Pubmed/MEDLINE,EMBASE,Cochrane Central Register of Controlled Trials(CCRCT),Cochrane Database of Systematic Reviews(CDSR)were searched by computer.The randomized controlled study of radiofrequency ablation for SIJ/LFJ was searched,and revman5 was used after literature quality evaluation 3 quantitative synthetic analysis.Results A total of 9 randomized controlled literatures and 560 patients were included.Meta analysis showed that radiofrequency ablation could improve the clinical effective rate(OR=16.41,95%CI=2.18-123.28,P=0.007)and excellent and good rate(OR=11.94,95%CI=5.02-28.36,P<0.001).Radiofrequency ablation could reduce VAS/NRS 1 week after treatment(WMD=-0.50,95%CI=-0.61~0.39,P<0.001),VAS/NRS 3 months after treatment(WMD=-1.37,95%CI=-1.82~0.91),VAS/NRS 6 months after treatment(WMD=-2.25,95%CI=-3.75~0.75,P=0.003),ODI 1 month after treatment(WMD=-14.86,95%CI=-28.73~0.99,P=0.04),and ODI 3 months after treatment(WMD=-6.00,95%CI=-10.74~-6.53,P=0.01).Radiofrequency ablation had no significant effect on VAS/NRS(WMD=-0.06,95%CI=-0.35-0.23,P=0.67)1 day after treatment,VAS/NRS(WMD=-0.85,95%CI=-1.91-0.21,P=0.12)and side effects(OR=0.25,95%CI=0.05-1.29,P=0.10)1 month after treatment.Conclusion Radiofrequency ablation is safe and effective in the treatment of SIJ/LFJ.

关 键 词：腰椎小关节 骶髂关节 慢性腰痛 射频消融 荟萃分析 

分 类 号：R441.1[医药卫生—诊断学]