【摘要】 目的探讨行脊神经后支射频热凝加腰三横突小针刀松解在腰骶部疼痛治疗中的疗效,并与单一方法对比。方法80例患者分为A组(单纯神经阻滞),B组(神经阻滞+小针刀松解术),C组(神经阻滞+射频治疗),D组(神经阻滞+小针刀松解术+射频治疗),每组20例。根据腰椎正侧位片,采用双侧椎弓根测量定位法,分别标志患侧第三腰椎横突尖部及脊神经后支相应的邵氏压痛点在体表的定位。腰三横突尖部行针刀松解;脊神经后支感觉、运动定位测定后,给予80℃、60s的射频治疗,共2个射频周期。观察视觉模拟评分法(VAS),记录治疗前、治疗后即时、24h,2周:静止VAS、运动VAS、腰三横突压痛VAS、邵氏点压痛VAS。组间比较用完全随机设计的方差分析,两两比较用SNK-q检验。结果D组在24h、2周与A、B、C组的比较P<0.05差异有统计学意义;B组在腰三横突压痛VAS与A组的比较P<0.05差异有统计学意义;C组与A组在邵氏点压痛VAS的比较P<0.05有统计学意义。结论慢性腰骶部疼痛,在诊断明确时,治疗上利用射频热凝加针刀松解联合施治,较单一方法好。更多还原

【Abstract】 Aim To compare the therapeutic efficacy of spinal nerve posterior branch radiofr equency ad ding waist third transverse process small needle knife brisement and single me thod in treating sacrolumbar pain.Methods Eighty patients with third lumbar ve rtebra transverse process syndrome and spinal nerve posterior branch syndrome,51males and 29fe-males,including 67cases of unilate ral pain a nd 13cases of bilateral pain,were equally divided into four groups at random :group A (simple nerve block),group B (nerve block +small needle knife bri s ement ),group C (nerve block +radiofrequency)and group D(nerve block +s mall needle knife brisement +radiofrequency).Bilateral pedicle of vertebral a rc h measurement was used to locate Shao’ s tenderness point as a marker of thi r d lumbar ver-tebra transverse process and spinal nerve posterior branch on th e surfac e of body.Small needle knife brisement was performed on the tip of thi rd lumbar vertebra transverse process,and sp inal nerve posterior branch receiv e d two courses of radiofrequency treatmen t(80℃,60s for one course).V isual analogue scales were examined before and after treatment,including sta t ic VAS,moving VAS,waist third transve rse process tenderness VAS and Shao’ s t enderness point VAS.Results The scores of VAS in the group D were significantly different from those of the groups A,B and C at 24hours and 2weeks respecti vely after treatment (P<0.05).Group A showed a significant difference i n the VAS scores of waist third transverse process and Shao’ s tenderness point from the groups B an d C respectively(P<0.05).Con-clusion Radiofrequenc y coagulation plus sm all needle knife brisement is more effective in treatment of chron ic waist-sacrum pain than single met hod.更多还原