硬膜外注射地塞米松棕榈酸酯治疗神经根型颈椎病的临床研究

Clinical research of epidural dexamethasone palmitate injection in the treatment of cervical spondylopathy of nerve root type

目的观察CT引导下硬膜外注射地塞米松棕榈酸酯治疗神经根型颈椎病青年患者的安全性及治疗效果。方法神经根型颈椎病青年患者90例，随机分为A组（地塞米松组）和B组（地塞米松棕榈酸酯组），在CT引导下行颈椎硬膜外穿刺置管后分别注射地塞米松和地塞米松棕榈酸酯。在治疗前及治疗结束后1周、4周及6个月时评估疼痛视觉模拟评分（VAS）、临床症状改善评分和优良率。结果在治疗后第6个月时A组VAS为（5．4±1．5），B组为（3．4±1．3），两者相比有统计学差异（P〈0.05）；临床症状改善评分A组为（2．6±0．5），B组为（1．4±0．5），两者相比有统计学差异（P〈0.05）；有效率A组为71．1％（32／45例），B组为95．6％（43／45例），两者相比有统计学差异（P〈0．05）。结论CT引导下颈部硬膜外注射地塞米松棕榈酸酯治疗神经根型颈椎病青年患者疗效优于地塞米松，是一种安全有效的方法。

Objective To investigate the safety and effects of epidural dexamethasone palmi- tare injection for the treatment of young patients with cervical spondylopathy by CT guidance. Methods Ninety young patients with cervical spondylopathy of nerve root type were randomly divided into group A and B. Dexamethasone and dexamethasone palmitate were injected into cervical epidural space under CT guidance in group A and B respectively. Clinical symptoms score, total effective rates and VAS were observed before the treatment and 1 week, 4 weeks and 6 months after the treatment. Results After 6 months, VAS, clinical symptoms score and total effective rates in group A were （5.4±1.5）, （2.6±0.5） and 71.1%（32/45 cases） respectively, and those were （3.4±1.3）, （1.4 ±0.5） and 95.6% （43/45 cases） respectively in group B, which were significantly different com- pared with group A respectively. Conelusion The effects of cervical epidural injection of dexamethasone palmitate under CT guidance for the treatment of young patients with cervical spondylopathy of nerve root type is better than that of dexamethasone, which is a safe and effective method.