两种颈部穿刺注药方法治疗颈椎病的临床观察 - 中华麻醉在线.doc

两种颈部穿刺方法治疗颈椎病的效果分析 赵晖1 邹瑾1 刘雁1 宋品2 （大连市中心医院　1麻醉科　2神经电生理室 辽宁省大连市 116033） [摘要]: 目的 比较用细针行颈椎椎旁神经阻滞和用Tuohy针行颈部硬膜外穿刺治疗颈椎病的有效性与安全性。方法 颈椎病患者120例，随机分为用细针行颈椎椎旁神经阻滞治疗组（60例）和用Tuohy针行颈部硬膜外穿刺治疗组（60例）。观察治疗一个疗程前后VAS评分、脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)的恢复情况以及临床症状和体征改善情况，综合评价治疗效果的优良率、有效率、随访一年以内的复发率、回顾1989年以来两种方法并发症的发生率。结果 两组治疗效果的优良率分别为73.3%、75%，总有效率分别为90%、93.3%，复发率分别为18.3%、15%，（p＞0.05)差异不显著。而两种方法并发症的发生率分别为2.9%、24.8%，(p＜0.05)有显著差异。 结论 细针治疗效果与Tuohy针治疗效果基本相同，但创伤小,并发症少， 操作简便, 患者易接受，是一项微创有效的治疗方法。 [关键词]：颈椎病；硬膜外；神经阻滞；细针穿刺；Tuohy 针穿刺； [中图分类号] R614.4 [文献标识码] A Treatment analysis of two cervical puncture and injection methods in cervical spondylosis therapy ZHAO Hui, ZOU Jing, LIU Yan, et al. (Anesthesiology department of Dalian Center Hospital, Liaoning Province 116033) [Abstract] Purpose: Comparison the validity and safety of cervical vertebra paravertebral nerve block treatment using fine needle aspiration and cervical epidural puncture treatment using Tuohy needle in cervical spondylosis therapy. Method: We randomly divided 120 cases of cervical spondylosis patients into group that was treated with paravertebral nerve block using fine needle (60 cases) and group that was treated with cervical epidural puncture using Tuohy needle (60 examples). After one treatment course, we observed the VAS grading, the restoration of brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) as well as the improvement of clinical symptoms and physical signs, overall evaluated merit rate, effectiveness of therapy results and recurrence rate made by a follow-up visit within one year, and reviewed complication incidence rate of two methods since 1989. Results: the merit rates of two groups in therapy results respectively are 73.3% and 75%, total effective rates respectively are 90% and 93.3%, recurrence rates respectively are 18.3% and 15%. There is no significant difference between the two groups after statistics analysis. But complications incidence rates of the two method