摘要
目的观察自控硬膜外腔镇痛(PCEA)治疗腰椎间盘突出症的疗效及硬膜外腔注射糖皮质激素对患者血糖的影响。方法将123例腰椎间盘突出症患者分为两组:PCEA组(n=55),硬膜外腔注射含糖皮质激素镇痛复合液,7d 1次,4次为1个疗程,首次硬膜外腔注射后行PCEA治疗7d;间断注药组(n=68),硬膜外腔注射含糖皮质激素镇痛复合液,7d 1次,4次为1个疗程。观察患者疗效及不良反应。于治疗前、治疗第9天、疗程结束次日监测空腹静脉血糖。结果治疗第9天及疗程结束次日两组患者视觉模拟量表(VAS)评分均明显降低,PCEA组分别为(3.26±0.41)分、(1.15±0.67)分,间断注药组分别为(4.98±0.66)分(、1.68±0.87)分,较治疗前差异均有统计学意义(P<0.01)。治疗第9天PCEA组优良率为76.4%,明显优于间断注药组(55.9%)。疗程结束次日PCEA组优良率(89.1%)仍高于间断注药组(82.4%),但差异无统计学意义(P>0.05)。两组患者血糖均较治疗前升高,但仍在正常值范围内。两组患者均无严重不良反应发生。结论PCEA治疗与间断硬膜外腔注射治疗腰椎间盘突出症临床疗效均较确切。但PCEA治疗在治疗早期能更迅速地缓解患者症状和体征。硬膜外腔注射糖皮质激素可引起患者血糖升高,但仍在正常值范围内。
Objective To evaluate the curative effects of patient controlled epidural analgesia（PCEA） for symptomatic lumbar disc herniation and the influence of epidural glucocorticoid injection on the blood-glucose. Methods Lumbar disc herniation cases （n = 123） were divided randomly into two groups. The patient controlled epidural analgesia group （PCEA group, n = 55）, accepted the epidural drugs injection every 7 days and 4 injections for a total treatment,accompaniment the first epidural drugs injection was fol- lowed by PCEA for 7 days; The epidural drugs injection group （DEDI group,n- 68） ,accepted the same epidural drugs injection ev- ery 7 days and 4 injections for a total treatment〈 To evaluate the curative effects with VAS scores and Macnab standard,monitoring blood-glucose before,on the eighth day and on the end of the treatment individually. Results VAS scores in both groups decreased significantly compared with pretherapy on the ninth day and on the end of the treatment：3.26±0.41 and 1.15±0.67 in the PCEA group and 4. 98±0.66 and 1.68±0.87 in the DEDI group（P〈0.01）. On the ninth day,the curative satisfactory rate was 76.4% in the PCEA group,which was much better than the DEDI group 55.9 % （P〈0.01）. On the end of the treatment, the curative satis- factory rate in the PCEA group was 89.1% higher than the DEDI group 82.4 % （P〈0.05）. The blood-glucose light increased in the both groups during the treatment which were still in the normal：on the ninth day and on the end of the treatment：（5.28±0.44） mmol/L and （5.52!0.33）mmol/L in the PCEA group and （5.43±0.46）mmol/L and （5.57± 0.36）mmol/L in the DEDI group （P〈0.05）. No significant side effect was found during the treatment. Conclusion PCEA and DEDI are both effective methods of lessen the symptoms and signs of lumbar disc herniation, but PCEA lessening the symptoms and signs more quickly early in the therapy compared with the DEDI. Blood-glucose light increased after the epidural drugs injection,which was still in the normal.
出处
《重庆医学》
CAS
CSCD
北大核心
2009年第20期2566-2568,2570,共4页
Chongqing medicine
关键词
腰椎间盘突出症
患者自控硬膜外腔镇痛
糖皮质激素
血糖
lumbar disc herniation
patient controlled epidural analgesia
glucocorticoid
blood-glucose
