發(fā)布時(shí)間：2018-07-10 12:57

  本文選題：椎間盤源性腰痛 + 椎間盤內(nèi)注射�。� 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：收集椎間盤造影結(jié)合亞甲藍(lán)盤內(nèi)注射治療的椎間盤源性腰痛患者的術(shù)前、術(shù)后(1、3、6、12月)的隨訪資料進(jìn)行分析,評(píng)估治療效果,為其診斷治療提供參考。方法：2012年10月-2013年12月,對(duì)31例經(jīng)正規(guī)保守治療3個(gè)月無效,考慮為椎間盤源性腰痛的患者,采用椎間盤造影結(jié)合椎間盤內(nèi)亞甲藍(lán)注射治療。通過對(duì)患者術(shù)前、術(shù)后(1、3、6、12月)的疼痛視覺模擬量表(visual analog scale, VAS)、腰椎功能障礙指數(shù)(Oswestry disability index, ODI)對(duì)患者腰痛減輕程度及腰椎功能改善程度進(jìn)行評(píng)估、通過對(duì)患者前、術(shù)后(3、6、12月)磁共振橫向弛豫時(shí)間(T2)、表觀彌散系數(shù)(apparent diffusion coefficient, ADC)評(píng)估患者椎間盤退變情況,以評(píng)價(jià)亞甲藍(lán)注射療效。結(jié)果：共28例患者完成隨訪。術(shù)后1、3、6、12個(gè)月VAS評(píng)分和ODI評(píng)分均較術(shù)前減少,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但術(shù)后VAS評(píng)分和ODI評(píng)分呈上升趨勢(shì)�；颊咝g(shù)后3、6個(gè)月磁共振橫向弛豫時(shí)間(T2)、表觀彌散系數(shù)(apparent diffusion coefficient, ADC)較術(shù)前無統(tǒng)計(jì)學(xué)差異(P0.05),但術(shù)后12個(gè)月患者T2值和ADC均較術(shù)前降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。所有病人無不良反應(yīng)及并發(fā)癥發(fā)生。結(jié)論：椎間盤造影亞甲藍(lán)盤內(nèi)注射治療椎間盤源性腰痛短期療效值得肯定,但長(zhǎng)期療效仍需要進(jìn)一步觀察研究；此外,該治療對(duì)于改善退變椎間盤結(jié)構(gòu)作用亦需要進(jìn)一步觀察研究。
[Abstract]:Objective: to analyze the follow-up data of patients with discogenic low back pain treated by intervertebral disc angiography combined with intradisc methylene blue injection (1 ~ 3 months, 6 months), and to evaluate the therapeutic effect and provide reference for diagnosis and treatment. Methods: from October, 2012 to December, 2013, 31 patients were treated with intervertebral disc angiography combined with intradisc methylene blue injection. The pain visual analogue scale (visual analog scale, VAS) and the lumbar spine disability index (ODI) were used to evaluate the degree of low back pain relief and the improvement of lumbar vertebrae function before and after operation. Magnetic resonance transverse relaxation time (T2) and apparent diffusion coefficient (apparent diffusion coefficient,) were used to evaluate intervertebral disc degeneration and evaluate the efficacy of methylene blue injection. Results: 28 patients were followed up. VAS scores and ODI scores decreased significantly at 1 and 12 months after operation (P0.05), but VAS and ODI scores increased after operation. There was no significant difference in magnetic resonance transverse relaxation time (T2) and apparent diffusion coefficient (apparent diffusion coefficient,) between 3 and 6 months after operation (P0.05), but at 12 months after operation, T2 and ADC decreased significantly (P0.05). No adverse reactions or complications occurred in all patients. Conclusion: the short-term efficacy of intradisc injection of methylene blue in the treatment of discogenic low back pain is positive, but the long-term effect still needs further observation and study. The effect of this treatment on the structural improvement of degenerative intervertebral disc also needs further observation and study.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R681.53

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