持续泵入曲安奈德治疗老年性腰椎管狭窄症疼痛的疗效观察

Observation of the clinical effect of continuously pumping the mixture of triamcinolone acetonide on the pain of lumbar spinal stenosis in ＇elder patients

目的观察应用镇痛泵持续恒定硬膜外注入曲安奈德混合液，治疗老年人腰椎管狭窄症疼痛的疗效。方法选择经CT或MRI确诊的65岁以上腰椎管狭窄症疼痛患者60例，随机分成A、B两组，每组30例，根据狭窄部位选择不同硬膜外穿刺点，置管成功后，首量推注0．75％罗哌卡因3ml，A组接镇痛泵持续泵入曲安奈德混合液100ml，持续50h。B组经硬膜外导管一次性注入曲安奈德混合液后，拔出导管。结果经过1个疗程的治疗后，A组优14例，占46，7％；良12例，占40．0％；优良率为86．7％（26／30例）．B组优3例，占10．0％；良11例，占36．7％；优良率为46．7％（14／30例）。A组疗效及优良率明显高于B组（P〈0．05），两组治疗后均未见明显并发症。结论镇痛泵持续泵入曲安奈德复合液治疗老年腰椎管狭窄症引起的疼痛，疗效显著，安全可靠。

Objective To observe the clinical effect of continuously pumping the mixture of triamcinolone acetonide through an epidural catheter to treatment of the elder＇s lumbar spinal stenosis pain. Methods Sixty patients, over 65 years old,with lumbar spinal stenosis pain diagnosed by CT or MRI were randomly divided into two groups, A and B, 30 cases in each group. Epidural puncture points were selected according to the different stenosis parts for placing the catheter and 0.75 % ropivacaine 3 ml was given for each patient. Then, 100 ml of the mixture of triamcinolone acetonide was pumped-in continuously for 50 hours in group A, while the patients in group B were given the mixture in bolus only one time, then the catheter was pulled out. Results After one course of the treatment, the effect in 14 cases （46.7%） was excellent, and in 12 cases （40. 0 %） was good and the rate of excellent and good was 86.7% （26/30 cases） in group A. While the number in group B were 3 cases （10.0%）, 11 cases （36.7%）, and the rate of excellent and good were 46.7% （14/30 cases） respectively. There were no complications in both groups. Conclusion Continuously pumping the mixture of triamcinolone acetonide is a safe and reliable method to treat the elder＇s lumbar spinal stenosis pain,comparing with bolus method.