细针硬膜外穿刺术临床应用研究

Clinical application of fine needle epidural puncture

目的探讨细针硬膜外穿刺术的临床疗效。方法选择适合行细针硬膜外穿刺术的患者1449例,根据穿刺部位分为中胸段组(T6-9组)、下胸段组(T9-12组)、上腰段组(T12-L3组)、下腰段组(L3-S1组)对比研究。采用Macnab疗效评定标准,全组患者于每次治疗后1周进行随访评估,以末次随访评定的疗效进行统计。结果各组优良率:T6-9组88.00%,T9-12组89.80%,T12-L3组93.27%,L3-S1组96.22%,各组优良率经统计学处理,差异有统计学意义(P<0.05);各组有效率:T6-9组96.00%,T9-12组95.92%,T12-L3组98.08%,L3-S1组98.82%,各组有效率经统计学处理,差异无统计学意义(P>0.1)。各组穿刺治疗阳性率经统计学处理,差异有统计学意义(P<0.05)。结论细针硬膜外穿刺术临床疗效确切,且腰段疗效优于胸段。

Objective To explore the clinical effect of fine needle epidural puncture. Methods 1449 patients suited to use the fine needle epidural puncture were selected. According to puncture site, the patients were divided into middle thoracic segments group （T6-9 group）,lower thoracic segments group（T9-12 group）,the upper waist section group （T12-L3 group） and low back group （L3- S1）. Macnab standard was used to evaluate the curative effect. All the patients were followed up 1 week after treatment to evaluate the effect,the curative effect of the final follow-up evaluation was analyzed. Results The excellent and good rates of the four groups were T6-9 group 88.00% ,T9-12 group 89.80%,T12-L3 group 93.27%,L3-S1 group 96.22%, the difference was statistically significant （P〈0.05）. The effective rates of the four groups were T6-9 group 96.00%,T9-12 group 95.92%,T12-L3 group 98.08%,L3-S1 group 98.82%, there was no statistically significant difference （P〉0.1）. Positive predictive value between groups puncture treatment after statistics processing,the difference was statistically significant （P〈0.05）. Conclusion Fine needle epidural puncture has definite curative effect,and the curative effect of waist segment is better than thoracic segment.