CT引导下射频热凝腰交感神经节治疗Ⅱ型复杂性区域疼痛综合征的临床研究

Treatment of complex regional pain syndrome type H by CT-guided radiofrequency thermocoagulation of lumbar sympathetic ganglia

目的研究CT引导下射频热凝腰交感神经节治疗Ⅱ型复杂性区域疼痛综合征的临床效果。方法将复杂性区域疼痛综合征Ⅱ型患者24例，随机分为A、B两组，每组12例。A组行CT引导下射频热凝毁损腰交感神经节治疗，B组行CT引导下乙醇毁损腰交感神经节治疗，治疗1周、1个月后两组按视觉摸拟评分（VAS）比较治疗效果，并观察治疗后并发症。结果A组1周后优良率91．7％（11／12例），B组1周后优良率83．3％（10／12例）；A组1个月后优良率83．3％（10／12例l，B组1个月后优良率75％（9／12例），两组治疗1周、1个月后优良率比较，差异均有统计学意义（P〈O．05）。两组治疗后并发症发生率，A组o％，B组16．7％（Z／12例），差异有统计学意义（P〈O．05）。结论CT引导下射频热凝毁损腰交感神经节治疗Ⅱ型复杂性区域疼痛综合征，效果优于CT引导下乙醇毁损腰交感神经节，并发症少于CT引导下乙醇毁损腰交感神经节。

Objective To observe the therapeutic effect of CT-guided radiofrequency thermo- coagulation of lumbar sympathetic ganglia on patients with complex regional pain syndrome type Ⅱ Methods Twenty-four patients with complex regional pain syndrome type ~ were randomly divided into group A and group B, 12 patients in each group. Lumbar sympathetic ganglia was destroyed by radiofrequency thermoeoagulation with CT-guided in group A and by absolute alcohol in group B. The effects of the two groups were compared with VAS and the rate of complications 1 week and 1 month after the treatment. Results Excellent and good rate was 91.7% （11/12 cases） in group A, and 83.3% （10/12 cases） in group after one week; Excellent and good rate was 83.3% （10/12 ca- ses） in group A, and 75%（9/12 cases） B in group B after one month. There was statistically signifi- cant difference （P（0. 05） between the two groups one week and one month after the treatment. Complication rate was 0% in group A and 16.7% （2/12 cases） in group B, which was statistically different （P〈0. 05）. Conclusion Radiofrequency thermoeoagulation of lumbar sympathetic ganglia is better than alcohol, and the rate of complications is less for the treatment of complex regional pain syndrome type Ⅱ.