摘要
目的探讨硬膜外腔前侧间隙置管连续阻滞联合腰椎低温等离子消融术治疗椎间盘源性腰痛的临床效果。方法选取椎间盘源性腰痛患者106例,根据治疗方案分为2组各53例。对照组给予硬膜外腔前侧间隙置管连续阻滞治疗,观察组给予硬膜外腔前侧间隙置管连续阻滞联合腰椎低温等离子消融术治疗。比较2组不同时点数字分级法(NRS)评分(术前、术后1周、术后1个月、术后3个月)、改良Macnab评定结果(术后1、3个月)、改良日本骨科学会腰痛功能评价表(M-JOA)评分(术前、术后1个月、术后3个月)以及血清白介素-1(IL-1)与白介素-6(IL-6)水平(术前、术后1个月、术后3个月)。结果2组术前及术后1周NRS评分比较无显著差异(P>0.05);术后1、3个月,观察组NRS评分显著低于对照组(P<0.05)。术后1、3个月,观察组Macnab评定优良率显著高于对照组(P<0.05)。术后1、3个月,观察组M-JOA评分显著高于对照组(P<0.05)。观察组术后1个月血清IL-1、IL-6水平显著低于对照组(P<0.05)。结论硬膜外腔前侧间隙置管连续阻滞联合腰椎低温等离子消融术治疗椎间盘源性腰痛患者安全、有效,可降低血清IL-1、IL-6水平。
Objective To investigate the clinical effect of continuous block with catheterization in the anterior space of epidural space combined with lumbar low temperature plasma ablation in treatment of patients with discogenic low back pain.Methods A total of 106 patients with discogenic low back pain were selected and divided into two groups according to the treatment plan.The control group was treated with continuous block with catheterization in the anterior space of epidural space,while the observation group was treated with continuous block with catheterization in the anterior space of epidural space combined with lumbar low temperature plasma ablation.The NRS scores(before operation,1 week after operation,1 month after operation,3 months after operation),the modified Macnab scores(before operation,1 month after operation,3 months after operation),the M-JOA scores(before operation,1 month after operation,3 months after operation)and the levels of interleukin-1(IL-1)and interleukin-6(IL-6)(before operation,1 month after operation,3 months after operation)were compared between the two groups.Results There were no significant difference in NRS scores between the two groups before operation and 1 week after operation(P>0.05).The NRS scores of the observation group were significantly lower than those of the control group at 1 and 3 months after operation(P<0.05).The excellent and good rates of Macnab in the observation group were significantly higher than those in the control group at 1 and 3 months after operation(P<0.05).At 1 and 3 months after operation,the M-JOA scores of the observation group were significantly higher than those of the control group(P<0.05).The serum levels of IL-1 and IL-6 in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Continuous block with catheterization in the anterior space of epidural space combined with lumbar low temperature plasma ablation is effective and safe in treatment of patients with discogenic low back pain,which can reduce serum IL-1 and IL-6 levels.
作者
王静
张晓丹
张淼
张军强
WANG Jing;ZHANG Xiaodan;ZHANG Miao;ZHANG Junqiang(Department of Pain,Xi′an Daxing Hospital,Xi′an,Shaanxi,710016)
出处
《实用临床医药杂志》
CAS
2020年第5期36-39,共4页
Journal of Clinical Medicine in Practice
关键词
硬膜外腔前侧间隙置管连续阻滞
腰椎低温等离子消融术
椎间盘源性腰痛
炎性因子
疗效
continuous block with catheterization in the anterior space of epidural space
lumbar low temperature plasma ablation
discogenic low back pain
inflammatory factors
efficacy
