【摘要】 目的:观察颈椎MRI图像测量引导行颈段硬膜外穿刺的有效性。方法:60例拟行颈段硬膜外穿刺置管治疗的慢性疼痛患者,随机均分为MRI图像引导组(M组)和盲探组(B组),分别实施颈段硬膜外穿刺操作。M组先通过PACS工作站在颈椎MRI图像上测量颈段硬膜外穿刺所需的各项参数,然后实施硬膜外穿刺操作。B组直接凭经验实施颈段硬膜外穿刺操作。记录两组患者的穿刺次数和穿刺操作时间、操作中和操作后的并发症。结果:M组的穿刺次数和穿刺时间显著少于B组(P<0.05),穿刺中神经根刺激症状和术后颈背部痛的发生率明显低于B组(P<0.05)。两组患者均未发生注入蛛网膜下腔、硬膜外血肿、硬膜外腔感染等严重并发症。结论:与盲探法相比较,MRI图像测量引导可明显减少穿刺次数和时间,减少穿刺损伤,避免穿刺的盲目性,提高穿刺成功率。更多还原

【Abstract】 Objective: To observe the effect of MRI image combined with C-arm fluoroscopy guided block of cervical epidural nerve. Methods: 60 patients, who were suffered with chronic pain and would receive cervical epidural nerve block, were randomly allocated to either MRI image-guided epidural nerve block group M or blindly epidural nerve block group B. In group M, the parameters of epidural nerve block were got from cervical MRI image measurement before the procedure, thereafter, the epidural nerve block was performed. In group B, cervical epidural nerve block was performed without image measurement. The number of attempts, blocking time and adverse events during the whole procedure were recorded. Results: The number of attempts, puncture time, incidence of nerve root irritation symptoms during the procedure and post-procedure pain of the back and neck in group M were all significantly lower than those in group B(P < 0.05). There was no severe complication including subarachnoid injection, epidural hematoma or epidural infection in both groups. Conclusion:Compared with "blind" cervical epidural nerve block, cervical MRI image-guided epidural nerve block can decrease the number of attempts, shorten puncture time and improve the success rate.更多还原