腰交感神经射频电凝联合臭氧自体血回输治疗Ⅱ型复杂性区域疼痛综合征临床疗效

Effect of radio frequency electrocoagulation combined with ozone autologous blood transfusion in the treatment of type Ⅱ complex regional pain syndrome.

目的观察射频电凝联合臭氧自体血回输治疗Ⅱ型复杂性区域疼痛综合征(CRPS Ⅱ)的效果。方法收集本院疼痛科就诊的CRPSⅡ患者41例,根据疼痛的的部位和性质,行射频电凝联合臭氧自体血回输,同时肌注依降钙素。观察治疗前、治疗后1、7、14、30 d患者VAS评分,患肢小腿中下胫前位置的皮肤温度、血流动力学指标(全血高切粘度、全血低切粘度、血浆粘度、血沉、红细胞压积、纤维蛋白原)的变化情况;并以VAS减分率评估治疗效果。结果治疗前与治疗后1 d、7 d、14 d、30 d时VAS评分对比差异有统计学意义,a P<0.01,且随时间延长VAS评分逐渐降低,疗效稳定;治疗前、治疗后皮肤温度对比差异有统计学意义,b P<0.05,皮肤温度治疗后升高;血流动力学各指标治疗前后对比差异有统计学意义,c P<0.05,治疗后明显降低,患者血液循环明显改善;疗效评价优28例(68.3%),良8例(19.5%),可4例(9.8%),无效1例(2.4%)。优良率87.8%(36/41),总有效率97.6%(40/41)。结论射频电凝联合臭氧自体血回输能明显改善CRPSⅡ患者疼痛症状,改善血液循环各指标,可作为CRPS Ⅱ的有效治疗方式。

Objective To observe the effect of radiofrequency electrocoagulation combined with ozone autologous blood transfusion(autotransfusion)in the treatment of type Ⅱ complex regional pain syndrome(CRPS Ⅱ).Methods A total of 41 CRPS Ⅱ patients in the Pain Department of our hospital were selected,who underwent radiofrequency electrocoagulation combined with ozone autologous blood transfusion,together with intramuscular injection of calcitonin according to the location and nature of the pain.The patient’s VAS scores before treatment,and 1,7,14,30 days after treatment,the changes of skin temperature,and hemodynamic indicators(high shear viscosity of whole blood,low shear viscosity of whole blood,plasma viscosity,erythrocyte sedimentation rate,hematocrit,and fibrinogen)of the anterior position of the milder and lower tibia in the affected shank were observed;and the VAS reduction rate was used to evaluate the treatment effect.Results There was a statistically significant difference in VAS scores before treatment and 1 d,7 d,14 d,30 d after treatment,a P<0.01,and the VAS score gradually decreased with time,and the efficacy was stable;the difference in skin temperature before and after treatment was statistically significant,b P<0.05,and skin temperature increased after treatment;the differences in hemodynamic indicators before and after treatment were statistically significant,c P<0.05,which were significantly reduced after treatment,and the patients’blood circulation was significantly improved.There were 28 cases of excellent efficacy evaluation(68.3%),8 cases of good(19.5%),4 cases(9.8%)of fair,and 1 case(2.4%)of invalid,with the excellent and good rate of 87.8%(36/41),and the overall effective rate of 97.6%(40/41).Conclusion Radiofrequency electrocoagulation combined with ozone autologous blood transfusion can significantly relieve the pain symptoms of CRPS Ⅱ patients and improve blood circulation indicators,which can be used as an effective treatment for CRPS Ⅱ.