摘要
目的研究骶管阻滞与硬膜外阻滞治疗腰椎间盘突出症临床应用价值，并对骶管阻滞的技术操作及适应证和禁忌证进行探讨。方法腰椎间盘突出症患者120例采用骶管阻滞（骶管组），于骶管腔注入（曲安奈德40mg、维生素B1 100mg、维生素B12 1mg、2％利多卡因100mg，用0．9％氯化钠稀释为20～30m1），2周1次，3次为1个疗程。并与硬膜外阻滞治疗腰椎间盘突出症患者120例（硬膜外组）的疗效进行对比观察。结果一次性穿刺成功率骶管组为93．3％（112／120），硬膜外组为82．5％（99／120），两组比较差异有统计学意义（P〈0．05）。治疗后骶管组、硬膜外组优良率分别为85．0％（102／120）、933％（112／120），差异无统计学意义（P〉0．05）；可差率分别为15．0％（18／120）、6．7％（8／120），差异有统计学意义（P〈0．05）。结论骶管阻滞和硬膜外阻滞均为治疗腰椎间盘突出症的有效疗法，能较快解除神经根压迫症状和强迫体位。而骶管阻滞较硬膜外阻滞操作简单、安全性较高。
Objective To study clinical application value of sacral and epidural block in treating lumbar intervertebral disc protrusion （LIDP）, and explore technical operation methods, indications and contraindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP（ sacral group ）, they were injected tfiamcinolone acetonide 40 mg, vitamin Bl 100 rag, vitamin Bl2 1 mg, 2% lidocaine 1{30 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block （ 120 cases, epidural group）. Results The achievement ratio of once puncture was 93.3% （112/120） in sacral group and 82.5% （99/120） in epidural group, P 〈 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0% （ 102/120 ） and 93.3% （ 112/120 ）, there was not obvious difference, P〉 0.05, but the fair and bad rate were 15.0%（18/120） and 6.7%（8/120）, there was ob- vious difference, P 〈 0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.
出处
《中国医师进修杂志》
2008年第12期14-16,共3页
Chinese Journal of Postgraduates of Medicine
关键词
曲安奈德
腰椎间盘突出症
骶管阻滞
Triamcinolone acetonide
Lumbar intervertebral disc protrusion
Sacral block
