椎旁神经阻滞与硬膜外阻滞治疗腰椎间盘突出症的临床观察

Clinical observation of paravertebral nerve block and epidural block in the treatment of lumbar intervertebral disc herniation

目的比较和评价椎旁神经阻滞(PVB)与硬膜外阻滞(EDB)治疗腰椎间盘突出症根性腰腿痛的临床疗效。方法60例腰椎间盘突出症患者随机分成A、B两组,A组30例采用PVB治疗,B组30例采用EDB治疗,两组均用得宝松(或地塞米松)+利多卡因+维生素B_(12)+生理盐水混合药液,每周1次,3次为1疗程。结果经过1个疗程的治疗后,总有效率A组与B组分别为96.7%(29/30例)和100%(30/30例),两组差异比较无统计学意义(P>0.05)。PVB组治疗后1例患者出现不良反应,EDB组治疗后有6例患者出现不良反应。两组不良反应率分别为3.3%与20%,相比差异具有统计学意义(P<0.05)。结论PVB与EDB均为治疗腰椎间盘突出症的有效方法,PVB操作简便且治疗期间出现的不良反应更少。

Objective To compare and evaluate the effects of paravertebral nerve block（PVB） and epidural block（EDB） in the treatment of lumbar intervertebral disc herniation. Methods Sixty patients with lumbar intervertebral disc herniation were randomly divided into two groups. Thirty patients in group A were treated by PVB and 30 cases in group B by EDB. Treatment in both groups was once a week and three times was in one course of treatment. Results After one course of treatment, the total effective rate was 96.7 % （29/30 cases） in group A and 100 % （30/30 cases） in group B （P〉 0. 05） after treatment, side effect was occurred in a patients in Group A and 6 patients in group B. Adverse reaction rates were 3.3% in group A and 20% in group B（P〈0. 05）. Conclusion The PVB and EDB are all effective approaches in the treatment of lumbar intervertebral disc herniation. The PVB maybe the easier way and the side effects are much less.