超声引导下小关节注射治疗腰椎小关节综合征.pdf

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1、·202·中国疼痛医学杂志ChineseJournalofPainMedicine2015，21r3doi：10．39698．issn．1006—9852．2015．03．009超声引导下小关节注射治疗腰椎小关节综合征朱婷肖礼祖。单莉莉。孙宇李加平郑虎山(广东医学院附属南山医院’超声科；疼痛科；妇科，深圳518052)摘要目的：观察超声引导下小关节注射治疗腰椎小关节综合征的临床可行性、有效性及安全性。方法：对4O例腰椎小关节患者采用实时超声弓f导下行小关节注射治疗。术后随访12周，应用视觉模拟评分法(VAS)评定术前、术后患者疼痛程度。结果：40例患者，需要观察的

2、腰椎小关节共57个，超声成功探测到54个小关节。对54个腰椎小关节行超声引导下注射镇痛复合液，均操作成功，未发生神经、血管损伤及其他并发症。治疗后1、4、12周的VAS评分均显著低于治疗前的VAS评分(P<0．001)。治疗后1周与12周VAS评分的差异有统计学意义(P<0．05)，但1周与4周、4周与12周的VAS评分差异均无统计学意义结论：超声引导下小关节注射治疗腰椎小关节综合征具有临床可行性，安全性好，疗效确切。关键词腰椎小关节；超声引导；注射ULTRASOUND-GUIDEDFACETJoTINJECTIONFORIM口E

3、ARFACETJOINTSSYN

4、DRoM匝ZHUTing，XIAOLi—Zu2SHANLi—Li，SUNYu，LIJia—Ping，ZHENGHu—Shan，(DepartmentofUltrasound，DepartmentofPainMedicine，DepartmentofGynaecology,NanshanHospitalAfiliatedtoGuangdongMedicalCollege，Shenzhen518052)AbstractObjective：Toexploretheclinicalfeasibility,efectivenessandsafetyofultrasound—

5、guidedfacetjointinjectioninthetreatmentoflumbarfacetjointssyndrome．Methods：Fortypatientswithlumbarfacetjointssyndromeunderwentfacetjointinjectionundertherealtimeultrasoundguidance．Allthepatientswerefollowedupfor12weeksandassessedbyvisualanaloguescale(VAS)beforeandafteroperation．Result

6、s：Atotalof57lumbarfacetjointsfrom40patientswereobservedundertheultrasound．Atotalof54lumbarfacetjointswereclearlyvisualized．54lumbarfacetjointswereinjectedwiththeanalgesiccompoundsolutionundertheUltrasound—guided．TheSuccessrateofultrasound-guidedpuncturewas100％．Therewerenolocalorsystem

7、iccomplications，suchasintravascularinjectionornerveinjection．VASscoresontheweek1，4and12postoperatiVe1yweresignificantlylowerthanthepreoperativescore(P<0．001)．ThereweresignificantdiferencebetweenVASscoresontheweek1and12postoperatively(P<0．05)．buttherewerenosignificantdiferencesbetweent

8、heweek1and4ortheweek4and12．Conclusion：Ultrasound—guidedfacetjointinjectionisafeasible，safeandefectivemethodforlumbarfacetjointssyndrome．KeywordsLumbarfacetjoint；Ul~asound—guided；Injection腰椎小关节综合征是一种腰椎小关节退行性佳或严重的并发症。超声引导作为一种新的影变或炎症引起的急、慢性腰部疼痛，临床上通常使像介入手段，已逐步应用于疼痛诊疗工作中，但对用小关节腔注射和脊神经后内侧支

9、阻滞治疗⋯