椎间盘造影亚甲蓝盘内注射治疗椎间盘源性腰痛的临床观察

发布时间：2018-07-10 12:57

本文选题：椎间盘源性腰痛 + 椎间盘内注射　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的：收集椎间盘造影结合亚甲蓝盘内注射治疗的椎间盘源性腰痛患者的术前、术后(1、3、6、12月)的随访资料进行分析,评估治疗效果,为其诊断治疗提供参考。方法：2012年10月-2013年12月,对31例经正规保守治疗3个月无效,考虑为椎间盘源性腰痛的患者,采用椎间盘造影结合椎间盘内亚甲蓝注射治疗。通过对患者术前、术后(1、3、6、12月)的疼痛视觉模拟量表(visual analog scale, VAS)、腰椎功能障碍指数(Oswestry disability index, ODI)对患者腰痛减轻程度及腰椎功能改善程度进行评估、通过对患者前、术后(3、6、12月)磁共振横向弛豫时间(T2)、表观弥散系数(apparent diffusion coefficient, ADC)评估患者椎间盘退变情况,以评价亚甲蓝注射疗效。结果：共28例患者完成随访。术后1、3、6、12个月VAS评分和ODI评分均较术前减少,差异有统计学意义(P0.05),但术后VAS评分和ODI评分呈上升趋势。患者术后3、6个月磁共振横向弛豫时间(T2)、表观弥散系数(apparent diffusion coefficient, ADC)较术前无统计学差异(P0.05),但术后12个月患者T2值和ADC均较术前降低,差异有统计学意义(P0.05)。所有病人无不良反应及并发症发生。结论：椎间盘造影亚甲蓝盘内注射治疗椎间盘源性腰痛短期疗效值得肯定,但长期疗效仍需要进一步观察研究；此外,该治疗对于改善退变椎间盘结构作用亦需要进一步观察研究。
[Abstract]:Objective: to analyze the follow-up data of patients with discogenic low back pain treated by intervertebral disc angiography combined with intradisc methylene blue injection (1 ~ 3 months, 6 months), and to evaluate the therapeutic effect and provide reference for diagnosis and treatment. Methods: from October, 2012 to December, 2013, 31 patients were treated with intervertebral disc angiography combined with intradisc methylene blue injection. The pain visual analogue scale (visual analog scale, VAS) and the lumbar spine disability index (ODI) were used to evaluate the degree of low back pain relief and the improvement of lumbar vertebrae function before and after operation. Magnetic resonance transverse relaxation time (T2) and apparent diffusion coefficient (apparent diffusion coefficient,) were used to evaluate intervertebral disc degeneration and evaluate the efficacy of methylene blue injection. Results: 28 patients were followed up. VAS scores and ODI scores decreased significantly at 1 and 12 months after operation (P0.05), but VAS and ODI scores increased after operation. There was no significant difference in magnetic resonance transverse relaxation time (T2) and apparent diffusion coefficient (apparent diffusion coefficient,) between 3 and 6 months after operation (P0.05), but at 12 months after operation, T2 and ADC decreased significantly (P0.05). No adverse reactions or complications occurred in all patients. Conclusion: the short-term efficacy of intradisc injection of methylene blue in the treatment of discogenic low back pain is positive, but the long-term effect still needs further observation and study. The effect of this treatment on the structural improvement of degenerative intervertebral disc also needs further observation and study.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.53

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