CAJ | 학술논문

目的研究骶管阻滞与硬膜外阻滞治疗腰椎间盘突出症临床应用价值,并对骶管阻滞的技术操作及适应证和禁忌证进行探讨.方法腰椎间盘突出症患者120例采用骶管阻滞(骶管组),于骶管腔注入(曲安奈德40 mg、维生素B1 100 mg、维生素B12 1 mg、2%利多卡因100 mg,用0.9%氯化钠稀释为20～30 ml),2周1次,3次为1个疗程.并与硬膜外阻滞治疗腰椎间盘突出症患者120例(硬膜外组)的疗效进行对比观察.结果一次性穿刺成功率骶管组为93.3%(112/120),硬膜外组为82.5%(99/120),两组比较差异有统计学意义(P<0.05).治疗后骶管组、硬膜外组优良率分别为85.0%(102/120)、93.3%(112/120),差异无统计学意义(P>0.05);可差率分别为15.0%(18/120)、6.7%(8/120),差异有统计学意义(P<0.05).结论骶管阻滞和硬膜外阻滞均为治疗腰椎间盘突出症的有效疗法,能较快解除神经根压迫症状和强迫体位.而骶管阻滞较硬膜外阻滞操作简单、安全性较高.
목적 연구저관조체여경막외조체치료요추간반돌출증림상응용개치,병대저관조체적기술조작급괄응증화금기증진행탐토.방법 요추간반돌출증환자120례채용저관조체(저관조),우저관강주입(곡안내덕40 mg、유생소B1 100 mg、유생소B12 1 mg、2%리다잡인100 mg,용0.9%록화납희석위20～30 ml),2주1차,3차위1개료정.병여경막외조체치료요추간반돌출증환자120례(경막외조)적료효진행대비관찰.결과 일차성천자성공솔저관조위93.3%(112/120),경막외조위82.5%(99/120),량조비교차이유통계학의의(P<0.05).치료후저관조、경막외조우량솔분별위85.0%(102/120)、93.3%(112/120),차이무통계학의의(P>0.05);가차솔분별위15.0%(18/120)、6.7%(8/120),차이유통계학의의(P<0.05).결론 저관조체화경막외조체균위치료요추간반돌출증적유효요법,능교쾌해제신경근압박증상화강박체위.이저관조체교경막외조체조작간단、안전성교고.
Objective To study clinical application value of sacral and epidural block in treating lumbar intervertehral disc protrusion (LIDP), and explore technical operation methods, indications and con-traindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP(sacral group), they were injected triamcinolone acetonide 40 mg, vitamin B1 100 mg, vitamin B12 1 mg, 2% lidocaine 100 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block (120 cases, epidural group). Results The achievement ratio of once puncture was 93.3% (112/120) in sacral group and 82.5% (99/120) in epidural group, P < 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0%(102/120) and 93.3%(112/120), there was not obvious difference, P>0.05, but the fair and bad rate were 15.0%(18/120) and 6.7%(8/120), there was ob-vious difference, P<0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.