国际麻醉学与复苏杂志   2018, Issue (9): 0-0
    
颈椎间孔射频复合激素注射治疗老年神经根型颈椎病临床观察
张云1()
1.上海长海医院
Clinical observation of radiofrequency thermocoagulation combined steroid injection in treatment of the aged cervical spondylotic radiculopathy
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摘要:

目的:评价超声联合CT引导颈椎间孔外侧入路行射频热凝复合消炎镇痛液注射治疗同单纯消炎镇痛液注射治疗老年CSR患者,观察两种不同治疗方法对老年CSR患者的临床疗效。研究方法:采用随机数字表法将40例老年CSR患者随机分为两组(n=20),试验组(T组)行射频热凝(55℃ 60s,60℃ 120s,65℃ 60s)+消炎镇痛液(配方:0.25%利多卡因+地塞米松10mg+碘海醇共4ml)注射治疗。对照组(C组)单纯行消炎镇痛液(配方:0.25%利多卡因+地塞米松10mg+无菌生理盐水共4ml)注射治疗。两组均在超声引导下行病变颈椎间孔外口靶点穿刺。评价术中有无血管、神经损伤 ;术后有无麻木、神经功能障碍的发生。记录治疗前、治疗结束后1个月以及治疗结束后6个月患者VAS评分,评价治疗结束后6个月临床疗效以及两组患者对治疗的满意度。治疗结果:所有患者均成功完成介入治疗,无患者出现血管、神经损伤。与治疗前相比,治疗后1个月、6个月VAS评分明显降低,上肢活动情况好转,术后无麻木、神经功能障碍发生。实验组临床疗效优良率高达85%,对照组优良率仅45%,两组数据对比差异有临床意义(P<0.05),两组患者满意度均较高。结论:超声联合CT引导颈椎间孔外口行射频热凝联合激素治疗老年CSR患者为一种操作简便且安全有效的治疗方法,值得在未来临床实践中继续深入推广和研究。

关键词: 超声; 射频; 老年人; 神经根型颈椎病
Abstract:

Objective In this study, ultrasound and CT-guided radiofrequency ablation combined with injection through the cervical intervertebral foramen in the treatment of geriatric patients with cervical spondylotic radiculopathy (CSR) and just injection in the treatment of geriatric patients with CSR,compared the clinical effects of two different treatments on senile patients with CSR. Methods Forty geriatric patients with CSR were randomly divided into two groups using a random number table(n=20): The test group (group T), The control group (group C). The course of treatment are under ultrasound for body surface location. Patients in Group T were treated with radiofrequency thermocoagulation (55 ℃ 60 s, 60 ℃ 120 s, 65 ℃ 60 s) +injection antiphlogistic and analgesic (prescription: 0.25% lidocaine + 10 mg dexamethasone + iohexol,a total of 4 ml ). Patients in Group C were only treated with anti?蛳inflammatory analgesic(prescription: 0.25% lidocaine + 10 mg dexamethasone + sterile saline,a total of 4 ml). The effectiveness evaluation mainly used the VAS score before treatment, 1 month after the treatment and 6 months after treatment to evaluate the clinical efficacy at 6 months after the treatment and the patients′ satisfaction. Results All patients were treated successfully. During the process of treatment and after treatment, no patient showed vascular and nerve injury. Also, no patient had numbness and neurological dysfunction after operation. Pain VAS scores of group T and group C were lower than the values of before, 1 month and 6 month after the treatment (P<0.05). Among them, pain VAS score of group T decreased more significantly. The excellent rate of group T was 85% but the rate of group C was only 45%. There was significant difference between two groups(P<0.05). Conclusions Ultrasound and CT-guided radiofrequency thermocoagulation combined with injection through the cervical intervertebral foramen in the treatment of senile patients with CSR is a simple, safe and effective treatment method.

Key words: Ultrasound; Radio frequency; Aged; Cervical spondylotic radiculopathy