神经根阻滞治疗颈源性疼痛疗效观察及对外周血T细胞亚群的影响
发布时间：2018-11-14 16:18
【摘要】：目的:观察超声引导下选择性颈神经根阻滞方法治疗颈源性疼痛的效果并探讨其对于外周血T细胞亚群的影响。 方法:选择2013年1月至2014年1月期间，行超声引导下选择性颈神经根阻滞治疗的颈椎间盘源性疼痛患者23例（实验组，A组）和行X线C型臂引导下颈椎旁阻滞治疗的颈椎间盘源性疼痛患者23例（对照组，B组）。对A组和B组全部患者，采用疼痛数字评分法(NRS)进行镇痛效果评估，同时记录患者术前、术后颈椎活动度评分(ROM)、每周疼痛发作次数和每次疼痛发作持续时间的变化。全部患者在治疗前24小时、治疗后24小时、治疗后3天、治疗后7天取静脉血2ml，应用流式细胞仪检测外周血T淋巴细胞亚群CD3+，CD4+和CD8+含量并进行比较。 结果:（1）镇痛效果方面，A组、B组两组患者治疗后与治疗前比较，两组患者治疗前NRS分别为7.08±2.00和6.96±2.11，两组患者治疗后24小时NRS分别为1.98±1.55和2.35±2.87，治疗后3天和治疗后7天NRS分别为2.33±2.40和3.44±3.50，3.67±3.23和4.67±3.45，两组患者治疗后24小时、3天、7天NRS均显著低于治疗前NRS（P0.01）；A组、B组两组患者治疗前每周疼痛发作次数分别为11.08±17.77和9.66±12.46，治疗7天后超声下选择性颈神经根阻滞组和传统盲探颈椎旁阻滞组疼痛发作次数分别为3.23±3.17和4.57±3.55，与治疗前比较，，差异具有统计学意义（P0.05）；A组、B组两组患者治疗前疼痛发作持续时间分别为7.55±6.44h和8.08±7.45h，治疗后疼痛发作持续时间分别为3.87±3.53h和4.07±3.75h，与治疗前比较，差异具有统计学意义（P0.05）；A组、B组两组患者治疗前颈椎活动度评分分别为2.69±2.12和2.93±2.11，治疗后颈椎活动度评分分别为1.51±0.63和1.48±0.51，与治疗前比较，差异具有统计学意义（P0.05）；A组、B组两组患者治疗前头颈部僵硬感觉率分别为86.96%和91.30%，治疗后头颈部僵硬感觉率分别为26.09%和52.17%，与治疗前比较，差异具有统计学意义（P0.05）。（2）免疫学机理方面，外周血T淋巴细胞亚群含量与治疗前比较，A组治疗后24小时、治疗后3天和治疗后7天的CD3+、CD4+和CD8+含量均显著高于治疗前（P0.01或P0.05）；B组CD3+、CD4+和CD8+含量在治疗后24小时和治疗后3天均显著高于治疗前（P0.05），治疗7天后与治疗前比较，无统计学差异（P0.05）。（3）A组与B组两组组间比较，治疗后24小时，A组NRS与B组比较，差异无统计学意义（P0.05），治疗后3天和治疗后7天，A组NRS低于B组，两组间比较，差异具有统计学意义（P0.05）；A组与B组两组组间比较，治疗后7天，A组疼痛发作次数和头颈部僵硬感觉率低于B组，两组间比较，差异具有统计学意义（P0.05）；A组与B组两组组间比较，治疗后24小时，A组外周血T淋巴细胞亚群CD3+，CD4+和CD8+含量与B组比较，差异无统计学意义，P0.05；治疗后3天和治疗后7天，A组外周血T淋巴细胞亚群CD3+，CD4+和CD8+含量均高于B组，两组间比较，差异具有统计学意义（P0.05）。 结论:超声下选择性颈神经根阻滞是治疗颈间盘源性疼痛的一种有效方法,其疗效优于传统的X线C型臂引导下颈椎旁阻滞方法，其作用机理可能与调节患者外周血T淋巴细胞亚群CD3+、CD4+和CD8+含量，提高患者提高细胞免疫能力相关。
[Abstract]:Objective: To observe the effect of selective cervical nerve root block in the treatment of cervical source pain and to study the effect of the selective cervical nerve root block on the subpopulation of peripheral blood T cells. Methods: From January 2013 to January 2014, 23 cases of cervical disc-source pain treated by selective cervical nerve root block under the guidance of ultrasound were selected (real 23 cases of cervical disc-source pain (control group, B) treated by the lateral block of the cervical disc under the guidance of the C-arm of the X-ray and the C-arm of the X-ray Group). A pain-based digital score (NRS) was used to evaluate the analgesic effect for all patients in the A and B groups, while recording the pre-operative, post-operative cervical motion score (ROM), the number of weekly pain episodes, and the duration of each pain Change: 24 hours before treatment, 24 hours after treatment, 3 days after treatment, 2 ml of venous blood for 7 days after treatment, and the content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocyte subpopulations was detected by flow cytometry. Results: (1) The group A and group B were compared with the treatment before and after the treatment. The NRS in the two groups was 7.08, 2.00 and 6.96/ 2.11, respectively, and the NRS in the two groups was 1.98, 1.55 and 2.35, respectively. The NRS was 2.33, 2.40 and 3.44, 3.50, 3.67, 3.23 and 4.67, 3.45, respectively. The number of weekly pain in group A and group B was 11.08, 177.77 and 9.66, respectively. 12. 46. After 7 days of treatment, the number of pain episodes in the selective cervical nerve root block group and the traditional blind cervical block group was 3.23, 3.17 and 4.57, 3.55, respectively, and the difference was statistically significant (P0.05). 5) The duration of pre-treatment in group A and group B was 7.55, 6.44h and 8.08-7.45h, respectively, and the duration of post-treatment pain was 3.87, 3.53h and 4.07-3.75h, respectively. In group A and group B, the degree of activity of the anterior cervical spine was 2.69, 2.12 and 2.93/ 2.11, respectively. The scores of the posterior cervical movement were 1.51, 0.63 and 1.48, 0.51, respectively. The stiffness of head and neck in group A and group B was 86. 96% and 91. 30%, respectively. The stiffness of head and neck after treatment was 26. 09% and 52. 17%, respectively. (2) The content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocyte subgroup was significantly higher than that before treatment (P0.01 or P0.05). The content of CD3 +, CD4 + and CD8 + in the treatment group was significantly higher than that before treatment (P0.05). (0. 05). (3) There was no significant difference between group A and group B in group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). In group A and group B, the number of pain and head and neck stiffness in group A were lower than that of group B, and the difference between group A and group B was statistically significant (P0.05); and group A and group B were compared and treated in group A and group B. The content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocytes in group A was significantly higher than that in group B after 24 hours, and the content of CD3 +, CD4 + and CD8 + in peripheral blood of group A was higher than that of group B after 3 days after treatment and 7 days after treatment. The difference was statistically significant between the two groups (P Conclusion: The selective cervical nerve root block under the condition of ultrasound is an effective method to treat the source pain of the cervical disc, and the curative effect is superior to that of the traditional X-ray C-type arm under the guidance of the cervical lateral block, and the mechanism of action may be the same as that of the T-lymph node in the peripheral blood of the patient. Increased number of CD3 +, CD4 + and CD8 + in the subpopulations of the cells, and increased the number of patients
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614.4
本文编号：2331675
[Abstract]:Objective: To observe the effect of selective cervical nerve root block in the treatment of cervical source pain and to study the effect of the selective cervical nerve root block on the subpopulation of peripheral blood T cells. Methods: From January 2013 to January 2014, 23 cases of cervical disc-source pain treated by selective cervical nerve root block under the guidance of ultrasound were selected (real 23 cases of cervical disc-source pain (control group, B) treated by the lateral block of the cervical disc under the guidance of the C-arm of the X-ray and the C-arm of the X-ray Group). A pain-based digital score (NRS) was used to evaluate the analgesic effect for all patients in the A and B groups, while recording the pre-operative, post-operative cervical motion score (ROM), the number of weekly pain episodes, and the duration of each pain Change: 24 hours before treatment, 24 hours after treatment, 3 days after treatment, 2 ml of venous blood for 7 days after treatment, and the content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocyte subpopulations was detected by flow cytometry. Results: (1) The group A and group B were compared with the treatment before and after the treatment. The NRS in the two groups was 7.08, 2.00 and 6.96/ 2.11, respectively, and the NRS in the two groups was 1.98, 1.55 and 2.35, respectively. The NRS was 2.33, 2.40 and 3.44, 3.50, 3.67, 3.23 and 4.67, 3.45, respectively. The number of weekly pain in group A and group B was 11.08, 177.77 and 9.66, respectively. 12. 46. After 7 days of treatment, the number of pain episodes in the selective cervical nerve root block group and the traditional blind cervical block group was 3.23, 3.17 and 4.57, 3.55, respectively, and the difference was statistically significant (P0.05). 5) The duration of pre-treatment in group A and group B was 7.55, 6.44h and 8.08-7.45h, respectively, and the duration of post-treatment pain was 3.87, 3.53h and 4.07-3.75h, respectively. In group A and group B, the degree of activity of the anterior cervical spine was 2.69, 2.12 and 2.93/ 2.11, respectively. The scores of the posterior cervical movement were 1.51, 0.63 and 1.48, 0.51, respectively. The stiffness of head and neck in group A and group B was 86. 96% and 91. 30%, respectively. The stiffness of head and neck after treatment was 26. 09% and 52. 17%, respectively. (2) The content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocyte subgroup was significantly higher than that before treatment (P0.01 or P0.05). The content of CD3 +, CD4 + and CD8 + in the treatment group was significantly higher than that before treatment (P0.05). (0. 05). (3) There was no significant difference between group A and group B in group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). In group A and group B, the number of pain and head and neck stiffness in group A were lower than that of group B, and the difference between group A and group B was statistically significant (P0.05); and group A and group B were compared and treated in group A and group B. The content of CD3 +, CD4 + and CD8 + in peripheral blood T-lymphocytes in group A was significantly higher than that in group B after 24 hours, and the content of CD3 +, CD4 + and CD8 + in peripheral blood of group A was higher than that of group B after 3 days after treatment and 7 days after treatment. The difference was statistically significant between the two groups (P Conclusion: The selective cervical nerve root block under the condition of ultrasound is an effective method to treat the source pain of the cervical disc, and the curative effect is superior to that of the traditional X-ray C-type arm under the guidance of the cervical lateral block, and the mechanism of action may be the same as that of the T-lymph node in the peripheral blood of the patient. Increased number of CD3 +, CD4 + and CD8 + in the subpopulations of the cells, and increased the number of patients
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614.4
【相似文献】
相关期刊论文 前9条
1 张增客,李英;颈神经根阻滞治疗神经根型颈椎病72例疗效观察[J];福建医药杂志;2001年02期
2 李浪平;顾明红;朱婵;李传明;王超;;复方当归注射液穴位注射联合颈神经根阻滞治疗神经根型颈椎病的临床研究[J];上海医学;2012年06期
3 唐译秀武;丛寿耆;;颈神经根阻滞[J];疼痛;1999年04期
4 冉传生;程蓉;;电针颈夹脊结合颈神经根阻滞治疗神经根型颈椎病72例[J];实用中医药杂志;2012年06期
5 武百山;刘声苹;倪家骧;;颈源性疼痛超声引导下选择性颈神经根阻滞对外周血细胞因子的影响[J];中国实验诊断学;2013年12期
6 李浪平;朱婵;李传明;张美荣;顾明红;;颈夹脊穴注射合颈神经根阻滞治疗神经根型颈椎病临床观察[J];上海针灸杂志;2014年06期
7 马文丰，郑秀英;颈斜角肌间沟入路颈神经根阻滞治疗根型颈椎病120例[J];临床麻醉学杂志;1994年04期
8 郑秀英,王新,马文丰;根型颈椎病致肩痛的诊治[J];临床麻醉学杂志;2001年12期
9 ;[J];;年期
相关硕士学位论文 前1条
1 曲丹;神经根阻滞治疗颈源性疼痛疗效观察及对外周血T细胞亚群的影响[D];吉林大学;2015年
本文编号：2331675
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2331675.html
最近更新
教材专著
