摘要
目的评价选择性脊神经根阻滞(SNRB)与椎旁神经阻滞(PVB)治疗腰椎间盘突出症的临床效果和安全性。方法选择60例腰椎间盘突出症引起腰腿痛的患者,随机分为DSA引导下选择性脊神经根阻滞组(A组)和椎旁神经阻滞组(B组),比较两组得宝松用量、局麻药混合液用量、加用镇痛药物口服情况。观察治疗前、治疗后14 d疼痛VAS评分、临床有效率和不良反应。结果 A组得宝松、局麻药混合液用量较B组少,加用镇痛药物比率A组比B组低,差异有统计学意义。治疗前两组的VAS评分差异无统计学意义,治疗后14 d A组VAS评分优于B组,A组总有效率明显优于B组,差异有统计学意义。两组不良反应相比A组少于B组,差异有统计学意义(P<0.05)。两组各有1例疼痛反复发作改手术治疗。结论 DSA引导下选择性脊神经根阻滞目标性强、准确性高、安全、临床效果好,值得临床推广,而腰椎旁神经阻滞因盲目注药存在药物注入血管和神经根袖内的潜在危险。
Objective To evaluate the clinical efficacy and safety of selective spinal nerve root block （SNRB） and paraver- tebral nerve block （PVB） in treatment of lumbar disc herniation. Methods Sixty cases of low back pain caused by lumbar disc herniation were randomly assigned to DSA under the guidance of selective spinal nerve root block （group A） and paraverte- bral nerve block （group B）. The amount of Diprospan, local anesthetic mixture dosage, oral analgesic drugs of two groups were compared. VAS score, clinical efficiency and adverse reactions were observed before and 14 days after treatment. Results The amount of Diprospan and local anesthetic mixture in group A were less than in group B, and the differences were sta- tistically significant; plus analgesic ratio in group A was lower than in group B, and the difference was significant. The dif- ference of pre-treatment VAS score was not statistically significant, but after treatment 14 days, VAS score of group A was better than that of group B, and clinical efficiency of group A was also better than that of group B, the differences were sta- tistically significant. Compared with group B, group A had Jess adverse reactions, and the difference was statistically signif- icant （P 〈 0.05）. Both groups had 1 case of patient with recurrent pain who changed to surgery. Conclusion DSA under the guidance of selective spinal nerve root block has safety and good clinical effect, is worthy Of clinical promotion.
出处
《中国现代医生》
2012年第12期42-44,67,共4页
China Modern Doctor
基金
湖南省岳阳市2011年第四批科技计划项目(20110026)
关键词
选择性神经根阻滞
椎旁神经阻滞
腰椎间盘突出症
腰神经根性痛
Selective nerve root block
Paravertebral nerve block
Lumbar intervertebral disc herniation
Lumbar nerve root pain
