摘要
目的探讨首次经椎间孔硬膜外注射有效间隔2周再次注射治疗腰椎间盘突出症的疗效是否优于疼痛加重后再次注射治疗的疗效。方法 2015-01-2016-01,于我科疼痛门诊就诊的腰椎间盘突出症患者80例。采用随机分组的方法分配至A和B组,每组40例。A组为首次治疗有效,间隔两周后再次硬膜外注射。B组为首次治疗有效,疼痛加重后再次行硬膜外注射。分别观察A组和B组治疗前VAS评分;A组连续注射后患者疼痛加重再次注射时间,以及B组单次注射后至疼痛加重再次注射时间。结果 A组需要再次注射的平均时间是(7.85±1.21)个月,B组是(4.59±1.53)个月。A组注射后VAS评分<3分的持续时间是(8.46±1.53)个月,B组的时间是(5.65±1.25)个月。A组与B组相比在再次注射时间和VAS评分<3分的维持时间有着显著的优势。结论首次治疗有效间隔2周重复经椎间孔硬膜外注射治疗腰椎间盘突出症疗效优于疼痛加重后再次注射的疗效。
Objective To determine whether repeat ESI at a prescribed interval of 2 weeks after the first injection could provide greater clinical benefit in patients with partial pain reduction than that provided by intermittent injection performed only when pain was aggravated. Methods From January 2015 to January 2016, 80 patients who had underwent transforaminal epidural steroid injection（TFESI） for treatment of lower back and radicular pain due to lumbar disc herniation （LDH） were enrolled. The patients were divided into 2 groups. Group A （n=d0） comprised partial responders （VAS 〉t 3 after first injection） who underwent repeat injection at a prescribed interval of 2 weeks after the first injection. Group B （n=40） comprised partial responders received repeat injection only for aggravation of pain. Various clinical data including total number of injection during one year, duration of VAS 〈3 during one year （VAS〈3 duration）, and time interval until aggravation of pain required additional injection after repeat injection in group A, or after first injection in group B （time to reinjection）, were assessed. Results In the whole population, the mean time to reinjection in group A was （7.85±1.21）months, that in group B was （4.59±1.53）months. The VAS 〈3 duration in groups A and B was （8.46±1.53）months and （5.65±1.25）months, respectively. Group A had significantly longer time to reinjection and longer VAS 〈 3 duration than group B. Conclusion Repeat TFESI conducted at 2 weeks interval after the first injection in partial responders contributed to greater clinical benefit compared to intermittent TFES! performed only upon pain aggravation.
出处
《颈腰痛杂志》
2017年第1期36-39,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎间盘突出症
经椎间孔硬膜外注射
重复注射
视觉模拟评分
疼痛部分缓解
lumbar disc herniation
transforaminal epidural steroid injection
repeat injection
visual analog scale
partial pain reduction
