【摘要】 目的探讨选择性腰神经根阻滞治疗神经根性腰腿痛后,根据外周血炎性细胞因子浓度的变化对治疗效果进行量化评价。方法选取90例神经根性腰腿痛患者,分为A、B、C三组各30例,分别给予传统椎旁阻滞、放射学引导的神经阻滞、超声引导的神经阻滞。比较三组疼痛改善情况及患者不同时点疼痛VAS(visual analogue scale)评分和肿瘤坏死因子(TNF)-α水平。结果三组治疗后6个月时VAS评分均低于治疗前,差异均有统计学意义(P<0.001),B、C组VAS评分明显低于A组,差异均有统计学意义(P<0.05);三组治疗后3天与2周TNF-α水平均较治疗前降低,差异有统计学意义(P<0.01),治疗后B、C组TNF-α表达低于A组,差异均有统计学意义(P<0.05)。结论外周血炎性细胞因子TNF-α血浆浓度的变化可以作为评价选择性腰神经根阻滞治疗效果量化指标,也可以通过该数值的测定,作为诊断性治疗明确具体受累神经根节段的依据。更多还原

【Abstract】 Objective After selective lumbar nerve roots block,some quantitatively evaluations of the curative effect were investigated according to the changes of plasma TNF-α concentration.Methods Ninety patients with nerve root lumbocrural pain were divided into A,B and C groups,30 in each group.Then,they were treated with traditional paravertebral block and nerve block under guidance of radiology or ultrasound,respectively.The improvement of pain,VAS at different times and changes in TNF-α level were compared among the three groups.Results The VAS score at six month after treatment were lower than that before treatment in the all three groups(P < 0.001).Moreover,the VAS score in the B and C groups were significantly lower than that in the group A(P <0.05).The TNF-α level after 3 days and 2 weeks of treatments were decreased when compared to before treatments(P < 0.01).Again,the reduction of TNF-α level in the B and C groups were significantly lower than that in the group A(P < 0.05).Conclusion The changes in plasma TNF-α concentration can be used as the quantitative standards to evaluate the curative effect of selective lumbar nerve roots block.It can also be regarded as a basis for diagnostic treatment to determine the specific affected nerve root segments.更多还原