本文選題：腰痛　切入點(diǎn)：脊神經(jīng)內(nèi)側(cè)支　出處：《首都醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察不同藥物在腰脊神經(jīng)內(nèi)側(cè)支阻滯(lumbar medial branch block,LMBB)治療腰痛的療效,以及影響療效的相關(guān)因素。方法:194例經(jīng)篩選的腰痛患者,根據(jù)阻滯用藥分為A組(利多卡因+得寶松,n=58)、B組(利多卡因+得寶松+甲鈷胺組,n=43)、C組(利多卡因+曲安奈德+甲鈷胺組,n=93),在C臂引導(dǎo)下行1次及以上的LMBB,每次LMBB間隔時間為2~4周,收集第一次阻滯前和末次阻滯后1天、1周、2周、1月、3月的疼痛數(shù)字評分(numeric rating scale,NRS),以疼痛緩解≥50%或NRS評分≤3分為有效,分析影響治療后1天和3月療效的相關(guān)因素,評價三個藥物組的療效及差異。結(jié)果:(1)在全部患者中有41%的患者有效時間≥3月,40%的患者有效時間持續(xù)1周~3月。(2)病程、阻滯側(cè)別、手術(shù)地點(diǎn)對療效無顯著影響(P0.05)。劑量2ml組對治療后1天的療效明顯優(yōu)于劑量≤2ml組(P0.05),兩組對治療后3月的療效無顯著性差異(P0.05)。有腰部扭傷史組對治療后3月的療效明顯優(yōu)于無腰部扭傷史組(P0.05)。(3)A、B、C三組治療前NRS評分無顯著差異(P0.05),治療后1天、1周、2周、1月、3月的NRS評分均明顯低于治療前基礎(chǔ)值(P0.05)。A組與B組、A組與C組、B組與C組在治療后1天、1周、2周、1月、3月的NRS評分均無顯著性差異(P0.05)。結(jié)論:LMBB可用于治療腰痛。阻滯劑量和腰部扭傷史對療效有影響,阻滯劑量2ml早期療效更好,遠(yuǎn)期療效相當(dāng);有腰部扭傷史者遠(yuǎn)期療效更好。甲鈷胺對療效無顯著影響;得寶松和曲安奈德對療效無顯著差異。
[Abstract]:Objective: to observe the therapeutic effect of different drugs on lumbar medial branch block LMBB in the treatment of low back pain. Methods: one hundred and forty-four selected patients with low back pain were enrolled in this study. According to the block medication, they were divided into two groups: group A (lidocaine), group B (lidocaine), group C (lidocaine triamcinolone acetonide), group C (lidocaine group), and the group B was treated with LMBB once or more under the guidance of C arm, each time with LMBB. The interval is 2 weeks, 4 weeks, The pain scores of rating scaleNRSs before the first block and 1 day after the last block, 1 week and 2 weeks after the first block and on January and March were collected. The pain relief 鈮，

本文編號：1563437