神经根筋膜鞘显影下注射富血小板血浆治疗神经病理性疼痛的疗效  

Efficacy of PRP injection under nerve root fascial sheath development in the treatment of neuropathic pain

作　　者：马斌祥[1] 姚鹏程 陈国栋[1] 鄢卫平[1] 宫玉锁[1] 郑建鹏 刘帅 MA Bin-Xiang;YAO Peng-Cheng;CHEN Guo-Dong(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China)

机构地区：[1]甘肃省中医院,甘肃兰州730050 [2]甘肃中医药大学

出　　处：《吉林医学》2024年第6期1284-1288,共5页Jilin Medical Journal

基　　金：甘肃省卫生健康行业科研计划项目[项目编号:GSWSKY2022-43]。

摘　　要：目的:探讨神经根筋膜鞘显影下注射富血小板血浆(PRP)与局部封闭治疗神经病理性疼痛(NP)的疗效。方法:选取2022年1月~2022年12月收治的符合纳入标准的60例NP患者为研究对象,随机分为治疗组与对照组各30例,对照组采用5%利多卡因注射液2.5 ml+醋酸泼尼松龙2.5 ml(0.125 g/5 ml)规格混合液5 ml单侧注射治疗;治疗组则采用神经根筋膜鞘显影下注射PRP 5 ml,两组患者共治疗12 w。分别记录患者治疗前、治疗后2 h、治疗后1 w、治疗后12 w的视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI)、下肢直腿抬高试验的离床面角度及行走距离测定。结果:治疗组治疗后2 h、治疗后1 w及12 w的VAS评分、ODI指数功能评分明显低于对照组(P<0.05);治疗组治疗后2 h、治疗后1 w及12 w的下肢直腿抬高试验、行走距离明显优于对照组(P<0.05);治疗组治疗有效率后期疗效显著优于对照组,且治疗期间均无不良反应发生。结论:经神经根筋膜鞘显影下注射PRP治疗神经病理性疼痛能获得更佳的临床疗效,较好地缓解患者神经病理性疼痛程度,促进其损伤神经修复及下肢功能的恢复,具有良好的安全性和可行性,为临床治疗病理性神经痛提供了新的治疗方案。Objective To observe the efficacy of platelet-rich plasma(PRP)injection under nerve root fascial sheath development compared with local closure in the treatment of neuropathic pain(NP).Method Sixty patients with pathological neuropathic pain who met the inclusion criteria and were admitted to the hospital from January 2022 to December 2022 were selected as research object,and they were randomly divided into treatment group(30 cases)and control group(30 cases).The control group was treated with 5ml of a mixture of 5%lidocaine injection and 2.5ml of acetate prednisolone(0.125 g/5 ml)for unilateral injection;while the treatment group was treated with PRP injection 5ml under the nerve root fascial sheath visualization,the two groups of patients were treated for a total of 12 weeks.The patients'visual analogue pain score(VAS score),ODI index,angle from bed and walking distance measurement of the lower limb straight leg raising test were recorded before,2 hours,1 week and 12 weeks after treatment respectively.Results The VAS score and ODI index functional score were significantly lower in the treatment group than in the control group at 2 hours,1 week and 12 weeks after treatment(P<0.05);the straight leg raising test of the lower limbs at 2 hours,1 week and 12 weeks after treatment(P<0.05)and the walking distance were significantly better than in the control group;a comparison of the treatment efficiency between the two groups revealed that the treatment efficacy was significantly better than that of the control group in the middle and late stages,and no adverse effects occurred during the treatment period.No adverse effects occurred during the treatment period.Conclusion The treatment of neuropathic pain with PRP injection under the nerve root fascial sheath can achieve better clinical efficacy,relieve the degree of neuropathic pain,promote the repair of damaged nerves and the recovery of lower limb function,and has good safety and feasibility,which provides a new treatment option for the clinical treatment of patholo

关 键 词：富血小板血浆 神经根封闭 局部封闭 神经病理性疼痛 

分 类 号：R681.53[医药卫生—骨科学]