摘要
目的观察超声引导下胸腰筋膜平面阻滞(TLIPB)联合体外冲击波(ESW)治疗慢性非特异性下腰痛(NLBP)的临床效果,为其精准定位和优化组合治疗提供参考。方法选择2018年2月至2020年1月收治的慢性NLBP患者90例,男48例,女42例,年龄<65岁,体重≤80 kg,BMI 21~28 kg/m^(2)。将患者随机分为三组:超声引导下TLIPB组(T组)、ESW组(E组)、超声引导下TLIPB联合ESW组(TE组),每组30例。评估治疗前、治疗后1、3、6个月VAS疼痛评分、日本骨科协会(JOA)评分,计算治疗后1、3、6个月优秀率、优良率,记录神经损伤、皮肤损伤、感染等并发症。结果与治疗前比较,治疗后1个月三组VAS疼痛评分明显降低(P<0.05),JOA评分明显升高(P<0.05);治疗后3个月E组、TE组VAS疼痛评分明显降低(P<0.05),JOA评分明显升高(P<0.05);治疗后6个月TE组VAS疼痛评分明显降低(P<0.05),JOA评分明显升高(P<0.05)。治疗后3、6个月TE组优秀率、优良率明显高于T组和E组(P<0.05)。三组均未发生神经损伤、皮肤损伤、感染等并发症。结论超声引导下TLIPB联合ESW治疗慢性NLBP的疗效优于单纯TLIPB或ESW,且无明显不良反应。
Objective To observe the clinical efficacy of ultrasound-guided thoracolumbar interfascial plane block(TLIPB)combined with extracoporeal shock wave(ESW)in treating chronic nonspecific low back pain(NLBP).Methods Ninety chronic NLBP patients included from February 2018 to January 2020,48 males and 42 females,aged<65 years,weighing≤80 kg,BMI 21-28 kg/m^(2),were randomly divided into three groups,30 patients in each group.In group T,TLIPB was performed under the ultrasound guidance.In group E,ESW was performed.In group TE,a combined therapy TLIPB+ESW was performed.Visual analogue scale(VAS)pain score and Japanese orthopaedical association(JOA)score were observed before and after 1,3,6 months of treatment.The treatment excellence rate ranking by the patients were recorded after 1,3,6 months of treatment.The related complications such as nerve injury,skin lesion or infection were also documented.Results Compared with before treatment,the VAS score decreased and JOA score increased in the three groups one month after treatment(P<0.05);the VAS pain score decreased and JOA score increased in groups E and TE three months after treatment(P<0.05);the VAS pain score decreased and JOA score increased in group TE 6 months after treatment(P<0.05).Compared with groups T and E,the treatment with excellent effect in group TE was much higher 3 and 6 months after treatment(P<0.05).There were no complications such as nerve injury,skin lesion or infection in the three groups.Conclusion Ultrasound-guided thoracolumbar interfascial plane block combined with extracoporeal shock wave is effective in treating chronic nonspecific low back pain with no obvious complications.
作者
杨小林
陈丽霞
任映梅
孙玉峰
宋杰
郑宏
YANG Xiaolin;CHEN Lixia;REN Yingmei;SUN Yufeng;SONG Jie;ZHENG Hong(Department of Anesthesiology,Rugao People’s Hospital,Rugao 226500,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2021年第7期736-740,共5页
Journal of Clinical Anesthesiology
基金
南通市卫生健康委员会科研立项课题(MB2019045)
南通市市级科技计划(指导性)项目(MSZ19142)
如皋市科技计划基金资助项目(201943,202012)。
关键词
超声引导
腰脊神经
胸腰筋膜平面阻滞
体外冲击波
非特异性下腰痛
Ultrasound-guided
Lumbar spinal nerve
Thoracolumbar interfascia plane block
Extracoporeal shock wave
Nonspecific low back pain
