CAJ | 학술논문

目的：探讨超声引导下臂丛神经根射频热凝联合阻滞治疗神经根型颈椎病的临床应用价值。方法收集2012年8月至2014年9月在广东医学院附属深圳南山医院临床诊断为神经根型颈椎病，拟行神经根靶点射频热凝联合阻滞治疗的65例患者。采用6~13 MHz高频超声引导下颈5~7神经根射频热凝及注药阻滞治疗，术前及术后均应用目测类比评分法（VAS）评定患者疼痛程度。结果62例患者均可清晰显示各段神经根，3例患者不能确定，需利用神经刺激仪定位确认，65例均穿刺成功，成功率100%，未发现神经损伤及其他并发症，术前及术后1周、4周、12周VAS评分分别为（8.65±0.47）、（3.68±0.49）、（2.51±0.32）、（1.73±0.21）分，治疗前与治疗后各时间点比较，差异均有统计学意义（t值=58.71、86.23、107.72，P值均<0.01）。结论超声引导下臂丛神经根射频热凝联合阻滞具有实时引导、安全、无辐射等优点，有望在临床上得到推广。
목적：탐토초성인도하비총신경근사빈열응연합조체치료신경근형경추병적림상응용개치。방법수집2012년8월지2014년9월재엄동의학원부속심수남산의원림상진단위신경근형경추병，의행신경근파점사빈열응연합조체치료적65례환자。채용6~13 MHz고빈초성인도하경5~7신경근사빈열응급주약조체치료，술전급술후균응용목측류비평분법（VAS）평정환자동통정도。결과62례환자균가청석현시각단신경근，3례환자불능학정，수이용신경자격의정위학인，65례균천자성공，성공솔100%，미발현신경손상급기타병발증，술전급술후1주、4주、12주VAS평분분별위（8.65±0.47）、（3.68±0.49）、（2.51±0.32）、（1.73±0.21）분，치료전여치료후각시간점비교，차이균유통계학의의（t치=58.71、86.23、107.72，P치균<0.01）。결론초성인도하비총신경근사빈열응연합조체구유실시인도、안전、무복사등우점，유망재림상상득도추엄。
ObjectiveTo explore the clinical application of ultrasound-guided radiofrequency thermocoagulaion in brachial plexus block.MethodsC5-C7 brachial plexus block was performed by 6-13 MHz high-frequency ultrasound probe in 65 patients with cervical spondylotic radiculopathy. Visual analogue scale (VAS) score were compared before and after treatment.ResultsThe brachial plexus was showed clearly in 62 patients; however, 3 patients had to be confi rmed by nerve stimulation positioning. The percentage of successful rate is 100%. There was no operation related nerve injury and other complications. The VAS score of preoperation and 1st, 4th and 12nd week after treatment was 8.67±0.76, 3.58±0.62, 2.46±0.2 and 1.77±0.28, respectively. There were significantly difference between before and after treatment (t=58.71, 6.23, 107.72, allP<0.01).ConclusionThe brachial plexus block using radiofrequency thermocoagulaion combined with ultrasound guidance is a safe and radiation-free treatment and warrants to be promoted in clinical practices.