摘要
目的：评价硬膜外注射利多卡因和倍他米松对腰椎术后神经病理性疼痛的治疗效果.方法：选择以下肢酸胀痛为主要症状的腰椎术后患者24例,行硬膜外置管并造影,术后持续泵入利多卡因;于术后第2、10天硬膜外推注倍他米松各1 ml;观察硬膜外造影与“责任”神经根的关系,记录手术前、术后第3天及1个月患者的NRS评分、ES评分、汉密尔顿焦虑评分（HAMA）,1月后对治疗效果进行评价.结果：既往手术区域呈造影剂缺失影, “责任”神经根均位于此部位附近1～2个节段.与术前相比,术后第3天及1个月时的NRS评分、ES评分及HAMA评分明显下降（P＜0.05）,1个月后治疗效果优良率为54.1％.结论：硬膜外应用利多卡因和倍他米松可有效缓解腰椎术后酸胀样疼痛.
Objective：To evaluate the efficacy of epidural injection with lidocaine and betamethasone on leg soreness due to failed back surgery syndrom （FBSS）.Methods：Twenty-four FBSS patients with leg soreness were performed epidural catheterization and myelography under the X-ray guidance.Lidocaine （0.5％） was continuously infused with 4.2 ml/h through the catheter for 10 days.The compound betamethasone 1ml was injected into epidural space at 2nd day and 10th day after catheterization.The relationship between epidural contrast diffusion and ＂responsibility＂ nerve root for leg pain was reserved,and NRS score,ES score,Hamilton Anxiety Scale were recorded before surgery,3rd day and 1 month after surgery.The treatment effect was evaluated with modified Macnab score.Results：There was a lack of contrast in the past surgery area,and the ＂responsibility＂ nerve roots were found to be located in 1-2 segments near the contrast lack area.Compared with the pre-operation,NRS score,ES score and HAMA score were decreased significantly （P ＜ 0.05） on 3 day and 1 month after surgery.The pain was significantly relieved in 54.1％ of the patients.Conclusion：Epidural injection of lidocaine and betamethasone can significantly relieved leg pain of FBSS patients.
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2014年第4期222-225,共4页
Chinese Journal of Pain Medicine
