硬膜外持续用药快速三维牵引治疗腰椎间盘突出症

THE TREATMENT OF LUMBAR INTERVERTEBRAL DISK HERNIA BY RAPID THREE-DEMENSION TRACTION AND CONTINUOUS INTRASPINAL APPLICATION OF DRUGS

观察探讨硬膜外麻醉下快速三维牵引并持续椎管内用药治疗腰椎间盘突出症的疗效、镇疼效果、全身反应和突出髓核的变化。选择病程、症状近似的 16 9例住院病人随机分为 2组 ,治疗组 73例 ,对照组 96例。治疗组在硬膜外麻醉下行快速三维牵引持续椎管内应用青霉素、复方丹参注射液、强的松龙、芬太尼、维生素、布比卡因等药物 3天。对照组仅行三维快速牵引治疗 ,并服非甾体类消炎药物、B族维生素及活血化瘀类中成药物。结果显示治疗组疗效、镇痛效果明显优于对照组 ,突出髓核回缩减小 ,住院天数缩短。在全身反应方面 2组无明显差异。表明快速牵引配合椎管内持续用药安全可靠 ,明显提高了近期和远期疗效 ,减少了副作用 。

The objective of the paper is to explore the therapeutic and analgesic effect of under-epidural-anesthesia rapid three-dimension traction (URTT) and continuous intraspinal application of the drugs on lumbar intervertebral disk hernia (LIDH). One hundred and sixty-nine cases of LIDH with similar disease courses and symptoms were randomly divided into two groups: the treated (n=73 cases) and the control (n=96 cases), the former was treated by UARTT and intracanal application of composite Red Sage injection, prednisoline, fentanyl, vitamins, etc for three days, and the latter was treated only by URTT and oral application of non-steroid anti-inflammaroty agents, B-vitamins, and processed TCD activating the blood circulation and removing the blood stasis. The results showed that the treated group had an obvious advantage over the control in the therapeutic and analgesic effect, nucleus-pulposus-hernia improvement and in-patient days decrease, but there was no significant difference between the two groups in the whole-body reaction, suggesting that URTT and continuous intraspinal application of the drugs are not only reliable and safe but also obviously improve the long- and short-term results and decrease the side-effects, having a good value of the clinical application.