摘要
目的比较4种不同的引导方式对背根神经节脉冲射频治疗下腰痛效果的影响。方法选择2018年6月至2020年6月佛山市中医院三水医院行背根神经节脉冲射频治疗下腰痛患者120例,按照随机数字表法分为C臂X线定位组(Ⅰ组)、CT定位组(Ⅱ组)、超声引导定位组(Ⅲ组)、超声联合C臂X线定位组(Ⅳ组),每组30例。记录并比较4组患者治疗前(T0)、治疗后24 h(T1)和治疗后1周(T2)、1个月(T3)、3个月(T4)的视觉模拟评分(VAS),治疗过程中穿刺次数、穿刺时间、一次穿刺准确率、射线暴露次数,以及治疗3个月后治愈率和显效率等。结果与T0比较,4组患者T1~4 VAS评分均降低(均P<0.05);Ⅳ组T1时VAS评分低于Ⅰ组(P<0.05)。穿刺次数和时间方面,Ⅲ组和Ⅳ组少于Ⅰ组和Ⅱ组(P<0.05);Ⅳ组射线暴露次数最少且一次穿刺准确率最高(P<0.05)。治疗3个月后治愈率比较,Ⅱ组及Ⅳ组较高,分别为46.7%及36.7%,但4组间比较差异无统计学意义(P>0.05)。结论4种引导方式穿刺的背根神经节脉冲射频治疗下腰痛均安全有效,超声联合C臂X线引导在减少射线暴露时间上优于其他3种引导方式。
Objective To compare different guiding methods for dorsal root ganglion (DRG) pulse radiofrequency in the treatment of low back pain.Methods From June 2017 to May 2019,120 patients with low back pain treated by pulse radiofrequency of DRG were randomly divided into C-arm X-ray positioning group (group Ⅰ),CT positioning group (Group Ⅱ),ultrasound-guided positioning group (Group Ⅲ),ultrasound combined with C-arm X-ray localization group (Group Ⅳ,n=30).The visual analogue score (VAS) was recorded before treatment (T0),24 hours after treatment (T1),1 week after treatment (T2),4weeks after treatment (T3) and 12 weeks after treatment (T4).The times of punctures,treatment time,the number of successful punctures in one time and the times of radiation exposure were recorded,and the cure rate and marked effective rate after 3months of treatment were also recorded and compared among 4 groups.Results Compared with T0,the VAS scores of T1-4in the four groups were significantly lower(P<0.05).Compared with T1,the VAS scores in group Ⅳ were significantly lower than those in groupⅠ(P<0.05).Group Ⅲ and Ⅳ had less X-ray exposure than groupⅠand group Ⅱ(P<0.05);and groupⅣhad the least X-ray exposure and the highest success rate of one time puncture among four groups(P<0.05).The cure rates of groupⅡand group Ⅳ were 46.7% and 36.7% respectively,there was no significant difference in cure rates among four groups(P>0.05).Conclus ion All four guiding methods are safe and effective in the treatment of low back pain by pulse radiofrequency;the ultrasound combined with C-arm X-ray is better than other three methods.
作者
邓铭锋
潘星安
徐德敏
廖荣宗
DENG Mingfeng;PAN Xing’an;XU Demin;LIAO Rongzong(Department of Anesthesiology,Sanshui District Hospital of Traditional Chinese Medicine,Foshan 528100,China)
出处
《浙江医学》
CAS
2020年第23期2552-2555,共4页
Zhejiang Medical Journal
基金
广东省佛山市科技局科技创新项目(1920001000795)。
关键词
背根神经节
脉冲射频治疗
下腰痛
Ganglia Spinal Pulsed
Radiofrequency Treatment
Low back pain
