【摘要】：目的評(píng)估實(shí)時(shí)超聲與CT融合成像引導(dǎo)選擇性腰骶神經(jīng)根阻滯治療的可行性及有效性。方法選取在我院疼痛科行單側(cè)腰4、5及骶1神經(jīng)根阻滯治療患者40例,將患者隨機(jī)分為兩組,分別行超聲-CT融合成像引導(dǎo)與單獨(dú)超聲引導(dǎo)穿刺,并由X線透視輔助調(diào)整穿刺針的位置,分別記錄兩組引導(dǎo)穿刺總時(shí)間及X線透視次數(shù)。穿刺到位后由疼痛科醫(yī)師進(jìn)行序貫治療,兩組后續(xù)治療方法和治療藥物相同。結(jié)果 40例患者均成功引導(dǎo)穿刺。超聲融合成像組穿刺過(guò)程總時(shí)間為13~18min,平均(15.7±1.4)min;融合成像時(shí)間為4~8min,平均(6.9±1.3)min;融合成像配準(zhǔn)誤差3.0~5mm,平均(4.1±0.61)mm;超聲最后顯示穿刺針尖距靶點(diǎn)距離D為1.2~2.2cm,平均(1.60±0.25)cm;X線透視次數(shù)3~5次,平均(3.9±0.8)次。單獨(dú)超聲引導(dǎo)組穿刺過(guò)程總時(shí)間為9~21min,平均(16.4±2.6)min;X線透視次數(shù)4~8次,平均(6.1±1.1)次。X線照射次數(shù)兩組差異有統(tǒng)計(jì)學(xué)意義(t=6.914,P0.001)。結(jié)論實(shí)時(shí)超聲-CT融合成像引導(dǎo)下選擇性腰骶神經(jīng)根阻滯是一種安全、有效的方法。
[Abstract]:Objective to evaluate the feasibility and effectiveness of selective lumbosacral nerve root block guided by real-time ultrasound and CT fusion imaging. Methods Forty patients with unilateral lumbar 4 and 1 nerve root block in our pain department were randomly divided into two groups: ultrasound-CT fusion imaging guidance and single ultrasound guided puncture. The position of the puncture needle was adjusted by X ray fluoroscopy, and the total time of guided puncture and the times of X ray fluoroscopy were recorded respectively. After the puncture was in place, the pain physician performed sequential treatment, and the follow-up treatment was the same as the treatment drug. Results the puncture was successfully guided in 40 patients. In the ultrasound fusion imaging group, the total time of puncture was 1318 minutes, the average time of (15.7 鹵1.4) min; fusion imaging was 4 minutes, the mean registration error of (6.9 鹵1.3) min; fusion imaging was 3. 0 鹵1. 3 mm, and the average (4.1 鹵0. 61) mm; ultrasound finally showed that the distance from the needle to the target point D was 1. 22 鹵2. 2 cm, and the average (1. 60 鹵0. 25) cm;X line fluoroscopy times was 3 times (3. 9 鹵0. 8). The total time of puncture in ultrasound guided group was 921 minutes, with an average of (16. 4 鹵2. 6) min;X fluoroscopy times of 48 times, and an average of (6. 1 鹵1. 1) times of X ray irradiation. There was a significant difference between the two groups (t = 6. 914, P 0. 001). Conclusion selective lumbosacral nerve root block guided by real-time ultrasound-CT fusion imaging is a safe and effective method.
【作者單位】： 北京大學(xué)第三醫(yī)院超聲診斷科;北京大學(xué)第三醫(yī)院疼痛科;
【分類號(hào)】：R445.1;R681.5;R816.8

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