【摘要】 目的:探讨不同程度腰椎间盘突出的患者对硬膜外神经阻滞的疗效。方法:收集2016年1月至2018年1月在增城区人民医院脊柱外科诊治的腰椎间盘突出症患者50例,根据腰椎间盘不同突出程度将患者分为A组(膨出、突出组)和B组(脱出组),经硬膜外神经阻滞治疗并随访3个月以上,分别在治疗前、治疗后2周、1个月及3个月进行NRS疼痛评分,对比分析两组患者的疗效。结果:整体患者治疗后的NRS评分明显降低,治疗前5.2±1.2,治疗后2周2.8±1.9,治疗后1个月2.4±1.5,治疗后3个月2.2±1.7,治疗后各时间点的评分与治疗前均有明显差异(P均<0.05);治疗后3个月68%患者疼痛缓解获得成功,66%患者整体感觉优良。A、B两组患者经治疗后NRS评分均明显降低,A组,B组:治疗前4.9±1.1,5.5±1.3;治疗后2周2.4±1.3,3.1±2.2,治疗后1个月2.2±1.4,2.5±1.6,治疗后3个月2.0±1.6,2.4±1.7;治疗后3个月,A组64.3%、B组72.7%患者疼痛缓解获得成功,两组间的差异无统计学意义(P=0.409);A组64.3%、B组68.2%患者整体感觉优良,两组间的差异同样无统计学意义(P=0.573)。结论:硬膜外神经阻滞对不同程度的腰椎间突出患者在短期内均能获得较理想的效果,可作为保守治疗与手术治疗之间的阶梯治疗。更多还原

【Abstract】 Objective:To investigate the effect of epidural block on patients with different degree of lumbar disc herniation. Methods:Collected 50 cases of lumbar disc herniation from January 2016 to January 2018 in the People′s Hospital of Zengcheng District. Patients were divided into group A(bulge and protrusion)and group B(prolapse)according to different degree of lumbar disc herniation. Patients were followed up for more than 3 monthsafter epidural block. NRS pain scores were scored before treatment,2 weeks,1 months and 3 months after treatment and then we comparison and analysis of the efficacy of two groups of patients. Result:The NRS score of the whole patient was significantly reduced after treatment,before treatment 5.2±1.2,2 weeks,1 months and 3 months after treatment as follow 2.8±1.9,2.4±1.5,2.2±1.7.The scores at different time points after treatment were significantly different from before treatment(P<0.05).3 months after treatment,68% patients were successfully relieved of pain and 66% patients have a good overall feeling.NRS scores were significantly reduced in both A and B two groups of patients after treatment. As fallowGroup A,group B,before treatment 4.9±1.1,5.5±1.3,2 weeksafter treatment 2.4±1.3,3.1±2.2,1 months after treatment 2.2±1.4,2.5±1.6,3 months after treatment 2.0±1.6,2.4±1.7. There were 64.3% in group A and 72.7% in group B achieved pain relief in 3 months after treatment.There was no statistical difference between the two groups(P=0.409). There were64.3% in group A and68.2% in group Bhad a good overall feeling. There was no statistical difference between the two groups also(P=0.573). Conclusion:Epidural block can achieve satisfactory result for patients with different degrees of lumbar intervertebral protrusion in a short time.It can be used as a stepwise treatment between conservative treatment and surgical treatment.更多还原