竖脊肌平面阻滞用于骨质疏松椎体压缩性骨折的效果及安全性分析  

Effectiveness and Safety of Erector Spinae Plane Block in the Treatment of Osteoporotic Vertebral Compression Fractures

作　　者：马应红 钱黎 简乾洪 董佳鑫 黄贤兵 翟月 廖丹 MA Yinghong;QIAN Li;JIAN Qianhong;DONG Jiaxin;HUANG Xianbing;ZHAI Yue;LIAO Dan(Department of Pain Management,Beijing Jishuitan Hospital Guizhou Branch,Guizhou,Guiyang 550000,china)

机构地区：[1]北京积水潭医院贵州医院疼痛科,贵州贵阳550000

出　　处：《中华灾害救援医学》2025年第1期11-16,21,共7页Chinese Journal of Disaster Medicine

基　　金：贵州省卫生健康委员会科学技术基金项目(gzwkj2022-384)。

摘　　要：目的探究竖脊肌平面阻滞(ESPB)用于骨质疏松椎体压缩性骨折(OVCF)的效果及安全性。方法选取2022年3月至2022年9月北京积水潭医院贵州医院收治的120例OVCF患者作为研究对象,按照随机数字表法分为对照组和研究组,每组60例,对照组采用止痛剂干预,研究组采用ESPB。比较两组术前(T0)、治疗4次后(T1)、出院前(T2)的简式McGill疼痛评分,肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白-1(HMGB-1)、超敏C反应蛋白(hs-CRP)水平,曲马多需求总次数、睡眠质量(PSQI)、生活质量(ECOS-16),调查患者满意度。结果研究组T0、T1、T2时刻的PRI、VAS、PPI存在递减趋势,且T1、T2时刻各项疼痛相关指标均低于对照组,差异有统计学意义(P<0.05);治疗后2周的TNF-α、HMGB-1、hs-CRP、PSQI低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);ECOS-16升高,观察组高于对照组,差异有统计学意义(P<0.05);研究组第4~7d肌注曲马多需求总次数低于对照组,治疗满意度高于对照组,差异有统计学意义(P<0.05)。结论ESPB应用于OVCF患者具有较好的镇痛效果,可抑制患者机体炎症反应,减少曲马多需求总次数,改善患者睡眠质量,提高患者生活质量及满意度。Objective To investigate the efficacy and safety of erector spinae plane block(ESPB)in patients with osteoporotic vertebral compression fractures(OVCF).Methods A total of 120 OVCF patients admitted to Guizhou Hospital of Beijing Jishuitan Hospital from March 2022 to September 2022 were selected for this study.They were randomly divided into two groups of 60 each using a random number table.The control group received analgesic intervention,while the study group received ESPB.The simplified McGill pain score,levels of tumor necrosis factor-alpha(TNF-α),high mobility group box-1(HMGB-1),and high-sensitivity C-reactive protein(hs-CRP)were compared pre-treatment(T0),after four treatment sessions(T1),and before discharge(T2).Additionally,total tramadol consumption,sleep quality(Pittsburgh Sleep Quality Index,PSQI),quality of life(ECOS-16),and patient satisfaction were assessed.Results In the study group,pain-related indices such as Pain Rating Index(PRI),Visual Analog Scale(VAS),and Present Pain Intensity(PPI)showed a decreasing trend at T0,T1,and T2,with T1 and T2 scores significantly lower than those in the control group(P<0.05).After two weeks of treatment,levels of TNF-α,HMGB-1,hs-CRP,and PSQI were significantly lower than before treatment,with the study group showing lower levels compared to the control group(P<0.05).The ECOS-16 score increased,with the study group scoring higher than the control group(P<0.05).The total tramadol consumption in the study group from days 4 to 7 was significantly lower than that in the control group,and patient satisfaction was higher in the study group compared to the control group(P<0.05).Conclusion The application of ESPB in patients with OVCF demonstrates a favorable analgesic effect,reduces the inflammatory response,decreases total tramadol consumption,improves sleep quality,and enhances both the quality of life and patient satisfaction.

关 键 词：竖脊肌平面阻滞 骨质疏松椎体压缩性骨折 生活质量 

分 类 号：R683.2[医药卫生—骨科学]