骶管滴注治疗腰椎间盘突出症临床疗效观察.docVIP

骶管滴注治疗腰椎间盘突出症临床疗效观察摘要：目的观察骶管滴注治疗腰椎间盘突出症的临床疗效。方法2000年1月～2006年6月治疗 6 000例腰椎间盘突出症患者，男性3 559例，女性2 441例，年龄17～62岁，平均42.7岁。将一定量局麻药、激素和神经营养类药物等经骶管裂孔缓缓滴注入骶管，4次为1疗程，每次治疗间隔10～14 d。结果随访1.5年，治愈67.2 %，显效27.8 %，好转3.5 %，无效1.5 %，总显效率95 %。结论骶管滴注治疗腰椎间盘突出症方法简单，疗效确切，易推广。 关键词：腰椎间盘突出症 ； 骶管滴注 中图分类号：R681.5＋3文献标识码： A文章编号：1672-979X(2008)03-0049-03 Clinical Efficacy Observation of Instillation of Sacral Canal for Treatment of Lumbar Disc Herniation XIE Jian-mei, HUANG Hong*, ZHOU Hong-xia (Department of Orthopaedics, the 100th Hospital of PLA, Suzhou 215007, China) Abstract ：Objective To observe the clinical efficacy of instillation of sacral canal for the treatment of lumbar disc herniation. Methods 6 000 patients with lumbar disc herniation, including 3 559 males and 2 441 females with an average age of 42.7 years from 17 to 62 years, were treated conservatively by instillation of sacral canal from January 2000 to June 2006. A certain amount of local anesthetics, hormones and neurotrophic substances was slowly dripped into sacral canal by sacral hiatus. 4 times was defined as a course of treatment with 10 to 14 days of time interval between every two treatments. Results All the patients were followed up with an average of 1.5 years. The 67.2 % of 6 000 patients were cured, 27.8 % were significant, 3.5 % were improved, 1.5 % were invalid and the total efficiency was 95 %. Conclusion The treatment of lumbar disc herniation by instillation of sacral canal is simple, effective and easy to be spread. Key words：lumbar disc herniation; instillation of sacral canal 腰椎间盘突出症的临床表现主要是腰腿痛。骶管滴注是将一定量的局麻药、糖皮质激素和神经营养药经骶裂孔注入骶管，药物进入骶管硬膜外腔后浸润腰骶神经根，并渗到椎间孔，沿骶丛神经扩散，阻断疼痛刺激传导，起到缓解腰腿痛的作用。方法简单，易操作，痛苦小，见效快，疗程短，治疗费用低，患者易接受。疗效优于单纯推拿、按摩或牵引，特别适于基层医疗单位推广。2000年1月至2006年6月我院门诊治疗腰椎间盘突出症6 000例，疗效显著。现报告如下。 1资料与方法 1.1临床资料 6 000例患者中，男3 559例，女2 441例，年龄17～62岁，平均42.7岁。病程15天～22年，平均10.4个月。主要因腰痛或腰腿痛来诊。一侧直腿抬高试验阳性2 497例，双侧直腿抬高试验阳性2 006例。X线检查示椎体退变3 845例，脊柱侧弯580例。全部患者均行CT检查， MRI检查824例。6 000例中，L1.2.~3.4 258例（4