硬膜外注射配合手法复位治疗急性腰椎间盘突出症的临床及电生理研究  

The electrophysiological and clinical study of peridural injection in combination with manual reduction for the treatment of acute lumbar disc herniation

作　　者：张建宏[1] 范建中[1] 杨哲[1] 彭楠[1] 

机构地区：[1]第一军医大学南方医院康复医学科,广州510515

出　　处：《中华物理医学与康复杂志》2002年第1期36-39,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨硬膜外注射配合手法复位对急性腰椎间盘突出症的疗效并观察体感诱发电位在病情评估中的作用。方法　将 46例急性腰椎间盘突出患者随机分为硬膜外注射组 2 3例和常规治疗组 2 3例 ,疗程 3～ 4周 ,治疗前及治疗后 1d、1周及疗程结束后应用目测类比评分法 (VAS)对疼痛进行评估 ,对症状、体征进行临床评定 ,治疗后进行疗效评定并复查双下肢体感诱发电位。结果　硬膜外注射即时止痛效果明显 ,可缩短疗程 ,配合手法复位治疗 ,疗效显著 ,优良率占 82 .6 %。两组患者患侧下肢体感诱发电位潜伏期延长 ,神经传导速度减慢 ,治疗后均有改善。结论　硬膜外注射配合手法复位对急性腰椎间盘突出症有较好的临床疗效 。Objective To explore the therapeutic effect of peridural injection and manual reduction on acute lumbar disc herniation and to observe the role of somatosensory evoked potential (SEPs) in the assessment of the illness. Methods Forty six cases of acute lumbar disc herniation were equally divided into the peridural injection group and the traditional treatment group. The clinical symptoms and signs as well as the scores of VAS were assessed before and on the seccond day, one week and 3～4 weeks after the treatment. The SEPs of the involved lower limb were also evaluated. Results Pain relieving effect in patients treated by peridural injection was prominent. In combination with manual reduction, peridural injection provided satisfactory therapeutic results. The total optimal therapeutic rate was up to 82.6%. Evaluation of SEPs before and after treatment demonstrated that both the increased latency of SEPs and decreased nerve conduction velocity were improved in patients with acute lumbar disc herniation Conclusion Peridural injection combining with manual reduction is an effective therapeutic option for treatment of patients with lumbar disc herniation,and the SEPs may be used as a measure for assessing the progress in these patients

关 键 词：硬膜外注射 手法复位 治疗 急性腰椎间盘突出症 体感诱发电位 

分 类 号：R681.53[医药卫生—骨科学]