实时超声-CT融合成像引导腰骶神经根阻滞治疗的临床研究

发布时间：2018-09-12 13:32

【摘要】：目的评估实时超声与CT融合成像引导选择性腰骶神经根阻滞治疗的可行性及有效性。方法选取在我院疼痛科行单侧腰4、5及骶1神经根阻滞治疗患者40例,将患者随机分为两组,分别行超声-CT融合成像引导与单独超声引导穿刺,并由X线透视辅助调整穿刺针的位置,分别记录两组引导穿刺总时间及X线透视次数。穿刺到位后由疼痛科医师进行序贯治疗,两组后续治疗方法和治疗药物相同。结果 40例患者均成功引导穿刺。超声融合成像组穿刺过程总时间为13~18min,平均(15.7±1.4)min;融合成像时间为4~8min,平均(6.9±1.3)min;融合成像配准误差3.0~5mm,平均(4.1±0.61)mm;超声最后显示穿刺针尖距靶点距离D为1.2~2.2cm,平均(1.60±0.25)cm;X线透视次数3~5次,平均(3.9±0.8)次。单独超声引导组穿刺过程总时间为9~21min,平均(16.4±2.6)min;X线透视次数4~8次,平均(6.1±1.1)次。X线照射次数两组差异有统计学意义(t=6.914,P0.001)。结论实时超声-CT融合成像引导下选择性腰骶神经根阻滞是一种安全、有效的方法。
[Abstract]:Objective to evaluate the feasibility and effectiveness of selective lumbosacral nerve root block guided by real-time ultrasound and CT fusion imaging. Methods Forty patients with unilateral lumbar 4 and 1 nerve root block in our pain department were randomly divided into two groups: ultrasound-CT fusion imaging guidance and single ultrasound guided puncture. The position of the puncture needle was adjusted by X ray fluoroscopy, and the total time of guided puncture and the times of X ray fluoroscopy were recorded respectively. After the puncture was in place, the pain physician performed sequential treatment, and the follow-up treatment was the same as the treatment drug. Results the puncture was successfully guided in 40 patients. In the ultrasound fusion imaging group, the total time of puncture was 1318 minutes, the average time of (15.7 卤1.4) min; fusion imaging was 4 minutes, the mean registration error of (6.9 卤1.3) min; fusion imaging was 3. 0 卤1. 3 mm, and the average (4.1 卤0. 61) mm; ultrasound finally showed that the distance from the needle to the target point D was 1. 22 卤2. 2 cm, and the average (1. 60 卤0. 25) cm;X line fluoroscopy times was 3 times (3. 9 卤0. 8). The total time of puncture in ultrasound guided group was 921 minutes, with an average of (16. 4 卤2. 6) min;X fluoroscopy times of 48 times, and an average of (6. 1 卤1. 1) times of X ray irradiation. There was a significant difference between the two groups (t = 6. 914, P 0. 001). Conclusion selective lumbosacral nerve root block guided by real-time ultrasound-CT fusion imaging is a safe and effective method.
【作者单位】：北京大学第三医院超声诊断科;北京大学第三医院疼痛科;
【分类号】：R445.1;R681.5;R816.8

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