摘要
目的探讨高压氧联合腰椎旁神经阻滞治疗腰椎间盘突出症的临床疗效。方法选择2010年1月至2012年1月聊城市中医医院骨科收治的顽固性腰椎间盘突出症患者108例,按照随机数字表法分为神经阻滞组(53例)和联合组(55例)。神经阻滞组单纯采用腰椎旁神经阻滞治疗;联合组采用高压氧联合腰椎旁神经阻滞治疗。观察两组治疗前、后不同时间的视觉模拟评分法(VAS)评分及胫神经运动传导速度(MCV)、腓总神经MCV变化情况。结果神经阻滞组、联合组治疗后1、2、3、4周VAS评分逐渐降低[神经阻滞组:(4.3±1.4)分,(3.1±0.7)分,(2.1±0.5)分,(1.7±0.4)分比(7.4±1.6)分;联合组:(3.4±1.3)分,(2.2±0.6)分,(1.4±0.2)分,(1.3±0.1)分比(7.5±1.5)分](均P<0.05),联合组VAS评分下降幅度大于神经阻滞组(P<0.05)。神经阻滞组、联合组治疗后1、2、3、4周胫神经MCV逐渐提高[神经阻滞组:(36±12)m/s,(39±12)m/s,(40±12)m/s,(42±12)m/s比(35±11)m/s;联合组:(39±12)m/s,(45±12)m/s,(50±12)m/s,(53±14)m/s比(34±11)m/s](均P<0.05);神经阻滞组、联合组治疗后1、2、3、4腓总神经MCV逐渐提高[神经阻滞组:(33±12)m/s,(37±12)m/s,(39±12)m/s,(42±13)m/s比(31±10)m/s;联合组:(38±11)m/s,(44±11)m/s,(50±12)m/s,(53±13)m/s比(31±10)m/s](均P<0.05),联合组胫神经和腓总神经MCV升高幅度大于神经阻滞组(P<0.05)。结论高压氧联合腰椎旁神经阻滞治疗腰椎间盘突出症可有效改善患者的临床疼痛症状及坐骨神经远段传导功能,效果显著优于单纯腰椎旁神经阻滞治疗。
Objective To investigate the clinical efficacy of treating lumbar disc herniation with hyper-baric oxygen combined with paravertebral lumbar nerve block.Methods A total of 108 patients with intrac-table lumbar disc herniation admitted to Liaocheng Hospital of Traditional Chinese Medicine from Jan .2010 to Jan.2012 were selected and randomly divided into nerve block group（53 cases）and combination group（55 cases） .Patients in nerve block group were simply treated with paravertebral lumbar nerve block;while pa-tients in combination group were treated with hyperbaric oxygen combined with paravertebral lumbar nerve block.Changes of visual analogue scale（VAS）,tibial nerve motor conduction velocity（MCV）,and peroneal nerve MCV of the two groups before treatment and at different times after treatment were observed .Results The VAS scores of both groups at one week,two weeks,three weeks,four weeks after treatment were gradually decreased[nerve block group：（4.3 ±1.4） scores,（3.1 ±0.7） scores,（2.1 ±0.5） scores,（1.7 ±0.4） scores vs （7.4 ±1.6）scores;combination group：（3.4 ±1.3） scores,（2.2 ±0.6） scores,（1.4 ±0.2） scores,（1.3 ±0.1） scores vs （7.5 ±1.5）scores] （all P〈0.05）.The tibial nerve MCV of both groups at one week,two weeks,three weeks,four weeks after treatment were gradually increased[nerve block group：（36 ±12） m/s,（39 ±12） m/s, （40 ±12） m/s, （42 ±12） m/s vs （35 ±11） m/s; combination group：（39 ±12） m/s,（45 ±12） m/s,（50 ±12） m/s,（53 ±14） m/s vs （34 ±11）m/s] （all P〈0.05）;the peroneal nerve MCV of both groups at one week, two weeks, three weeks, four weeks after treatment were gradually increased[nerve block group：（33 ±12） m/s,（37 ±12） m/s,（39 ±12） m/s,（42 ±13） m/s vs （31 ±10）m/s;combination group：（38 ±11） m/s,（44 ±11） m/s,（50 ±12） m/s,（53 ±13） m/s vs （31 ±10） m/s] （all P〈0.05）.Conclusion Treating lumbar disc herniation with hyperbaric oxygen com-bined with paravertebral lumbar nerve block can effectively improve the clinical pain symptoms of the patients and the sciatic nerve distal conduction function,which has significantly better effect than treatment with sim-ple paravertebral lumbar nerve block.
出处
《医学综述》
2015年第11期2093-2095,共3页
Medical Recapitulate
关键词
腰椎间盘突出
高压氧
腰椎旁神经阻滞
Lumbar disc herniation
Hyperbaric oxygen
Paravertebral lumbar nerve block
