鸡尾酒注射防治可视化环锯关节突成形所致下腰背痛的研究  

Study on the prevention and treatment of low back pain caused by visualized circular saw joint process shaping with cocktail injection

作　　者：喻巍 何嘉承[1] 周欢斌 李超 李强[1] YU Wei;HE Jiacheng;ZHOU Huanbin;LI Chao;LI Qiang(Department of Orthopedics,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院骨科,江西九江332000

出　　处：《当代医学》2024年第22期153-156,共4页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202311445)。

摘　　要：目的探讨鸡尾酒注射防治可视化环锯关节突成形所致下腰背痛的治疗效果。方法选取2019年2月至2023年2月于九江市第一人民医院接受经椎间孔脊柱镜(transforaminal spine lens,TESSYS)术的30例腰椎间盘突出症患者作为观察组,另选取同期随访的36例TESSYS术后常规处理患者作为对照组。对照组术后采用常规处理,观察组于TESSYS术后即刻在C臂透视下行同侧关节突周围鸡尾酒注射疗法(鸡尾酒配方由罗哌卡因+复方倍他米松+氨甲环酸+肾上腺素组成),比较两组临床疗效、疼痛程度[视觉模拟评分法(visual analogue scores,VAS)]、腰部功能[Oswestry功能障碍指数(Oswestry dysfunction index,ODI)]。结果术后3 d、6个月,两组治疗总有效率比较差异无统计学意义;术后1、12个月,观察组治疗总有效率均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组ODI高于治疗前,VAS评分低于治疗前,且观察组ODI评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05)。结论鸡尾酒注射防治可视化环锯关节突成形所致下腰背痛的疗效显著,可减轻患者疼痛程度,改善腰部功能,值得临床推广应用。Objective To explore the therapeutic effect of low back pain caused by visualized circular saw joint process shaping with cocktail injection. Methods 30 patients with lumbar disc herniation who underwent transforaminal endoscopic spine lens (TESSYS) at the Jiujiang NO.1 People's Hospital from February 2019 to February 2023 were selected as the observation group, 36 patients who received routine treatment after TESSYSsurgery were followed up as the control group. The control group was treated with routine treatment after surgery, the observation group wastreated with cocktail injection around the ipsilateral articular process under C-arm fluoroscopy immediately after TESSYS (the cocktail formula consistedof ropivacaine + compound betamethasone + tranexamic acid + epinephrine). The clinical efficacy, pain degree (visual analogue scores [VAS])and lumbar function (Oswestry dysfunction index [ODI]) were compared between the two groups. Results There was no significant difference inthe total effective rate between the two groups at 3 d and 6 months after operation;at 1 and 12 months after operation, the total effective rate in the observationgroup was higher than that in the control group, and the differences were statistically significant (P<0.05). After treatment, the ODI score ofthe two groups were higher than before treatment, VAS score were lower than before treatment, and the ODI score in the observation group was higherthan the control group, VAS score was lower than the control group, and the differences were statistically significant (P<0.05). Conclusion The effectof low back pain caused by visualized circular saw joint process shaping with cocktail injection is significant, which can reduce the pain degreeof patients and improve the function of the waist, and is worthy of clinical promotion and application.

关 键 词：可视化环锯关节突 鸡尾酒 腰椎间盘突出症 注射治疗 腰背痛 

分 类 号：R68[医药卫生—骨科学]