臭氧注射联合腰大肌间沟阻滞治疗腰椎间盘突出症的临床研究(1)
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【摘要】 目的探讨经皮穿刺臭氧盘内注射联合腰大肌间沟阻滞治疗腰椎间盘突出症(LDH)的疗效及安全性。方法 经临床检查和CT或MRI确诊为LDH患者68例,随机分为对照组和观察组各34例。均行C型臂X线机引导下臭氧消融治疗。观察组患者在臭氧消融术后进行腰大肌间沟阻滞治疗,对照组仅做臭氧消融术。治疗后1周、1个月,6个月分别采用VAS评分和改良MacNab法进行评价。结果 治疗后1周、1个月、6个月的优良率在对照组分别为58.8%、70.6%、88.2%;在观察组分别为79.4%、85.3%、91.2%。两组在治疗后1周,1个月优良率均有显著性差异(P<0.05)。所有患者均未发现严重并发症。结论 经皮穿刺臭氧盘内注射联合腰大肌间沟阻滞是一种有效、安全的微创方法, 可以加速腰腿疼痛症状的改善,提高治疗LDH的近期疗效。
【关键词】臭氧,腰大肌间沟阻滞,腰椎间盘突出症
Clinical research on the ozone injection plus psoas compartment block for the treatment of lumbar disc herniation
LENG Si-hong, ZHANG Dong-mei, LUO Qiong-jia. DepartmentofPain Medicine,Shenzhen Hengsheng Hospital,Shenzhen Guangdong 518102,China
【Abstract】 Objective To investigate the curative effect and safety of percutaneous intradisc injection of ozonecombined with psoas compartment block (PCB) for thetreatment of lumbar disc herniation(LDH). Methods Sixty-eight patients with LDH confirmed by CT or MRI were randomly divided into control group (CG,n=34) and observation group (OG,n=34),and patients of both groups underwent C-arm X ray guided ozone ablation.The patients in OG received PCB after ozone ablation. In CG, the patients only received ozone ablation. Clinical outcome was assessed on the 7 d、30 d and 6 months after treatment according to visual analogue scale(VAS) and the modified MacNab method. Results The excellent-good rate of 7 d、30 d、and 6 months after therapy in CGwas58.8%、70.6%and 88.2% respectively,and that inOG was 79.4%、85.3% and 91.2% respectively. There were significant differences between two groups in theexcellent-good rate at 7 d and 30 d(P<0.05). No serious complication occurred.Conclusion Percutaneous intradisc injection of oxonecombined with PCB is an effective and safe method for the treatment of LDH. It improves the pain relief and the short-term clinical effects.
【Key words】 Ozone;Psoas compartment block;Lumbar disc herniation
作者单位:518102深圳恒生医院疼痛科
臭氧治疗腰椎间盘突出症(LDH)是近年来开展的一项新的微创介入治疗技术。单纯椎间盘内注射虽然临床中长期效果明显,但治疗后起效较慢,6个月效果最佳[1,2]。腰大肌间沟神经阻滞是通过把得宝松复合液注入腰大肌间沟内,药物到达病变周围,改善其炎性环境,起到止痛、消炎作用[3]。本文应用椎间盘内臭氧注射联合腰大肌间沟阻滞治疗LDH,并与单纯臭氧治疗进行比较研究。现报告如下。
1 资料与方法
1.1 一般资料 2008年5月至2009年10月收治的LDH患者68例,全部患者术前经CT或MRI检查证实为腰椎间盘突出或膨出,且与临床症状、体征一致 ......
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