不同药物在腰脊神经内侧支阻滞治疗腰痛中的疗效观察

发布时间：2018-03-04 01:01

  本文选题：腰痛　切入点：脊神经内侧支　出处：《首都医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察不同药物在腰脊神经内侧支阻滞(lumbar medial branch block,LMBB)治疗腰痛的疗效,以及影响疗效的相关因素。方法:194例经筛选的腰痛患者,根据阻滞用药分为A组(利多卡因+得宝松,n=58)、B组(利多卡因+得宝松+甲钴胺组,n=43)、C组(利多卡因+曲安奈德+甲钴胺组,n=93),在C臂引导下行1次及以上的LMBB,每次LMBB间隔时间为2~4周,收集第一次阻滞前和末次阻滞后1天、1周、2周、1月、3月的疼痛数字评分(numeric rating scale,NRS),以疼痛缓解≥50%或NRS评分≤3分为有效,分析影响治疗后1天和3月疗效的相关因素,评价三个药物组的疗效及差异。结果:(1)在全部患者中有41%的患者有效时间≥3月,40%的患者有效时间持续1周~3月。(2)病程、阻滞侧别、手术地点对疗效无显著影响(P0.05)。剂量2ml组对治疗后1天的疗效明显优于剂量≤2ml组(P0.05),两组对治疗后3月的疗效无显著性差异(P0.05)。有腰部扭伤史组对治疗后3月的疗效明显优于无腰部扭伤史组(P0.05)。(3)A、B、C三组治疗前NRS评分无显著差异(P0.05),治疗后1天、1周、2周、1月、3月的NRS评分均明显低于治疗前基础值(P0.05)。A组与B组、A组与C组、B组与C组在治疗后1天、1周、2周、1月、3月的NRS评分均无显著性差异(P0.05)。结论:LMBB可用于治疗腰痛。阻滞剂量和腰部扭伤史对疗效有影响,阻滞剂量2ml早期疗效更好,远期疗效相当;有腰部扭伤史者远期疗效更好。甲钴胺对疗效无显著影响;得宝松和曲安奈德对疗效无显著差异。
[Abstract]:Objective: to observe the therapeutic effect of different drugs on lumbar medial branch block LMBB in the treatment of low back pain. Methods: one hundred and forty-four selected patients with low back pain were enrolled in this study. According to the block medication, they were divided into two groups: group A (lidocaine), group B (lidocaine), group C (lidocaine triamcinolone acetonide), group C (lidocaine group), and the group B was treated with LMBB once or more under the guidance of C arm, each time with LMBB. The interval is 2 weeks, 4 weeks, The pain scores of rating scaleNRSs before the first block and 1 day after the last block, 1 week and 2 weeks after the first block and on January and March were collected. The pain relief 鈮，

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