小针刀联合神经阻滞术治疗腰3横突综合征疗效观察

Clinical Observation of Needle Knife Surgery Combined with Nerve Block for Treating Third Lumbar Transverse Process Syndrome

目的:对腰3横突综合征患者实施小针刀联合痛点神经阻滞术,并观察其临床疗效。方法:回顾性分析我院近期收治的90例腰3横突综合征患者,分成联合组(采用小针刀联合神经阻滞术治疗)、小针刀组(单纯采用小针刀治疗)和神经阻滞组(单纯采用神经阻滞术治疗),每组各30例。记录并观察3组治疗有效率、治疗前后视觉模拟评估法(VAS)评分及日本骨科协会评估治疗(JOA)分数。结果:联合组、小针刀组及神经阻滞组总有效率分别为96.7%,86.7%和93.3%,差异无统计学意义(P>0.05);3组治疗前VAS评分及JOA评分比较,差异无统计学意义(P>0.05),治疗1周后,联合组较小针刀组及神经阻滞组VAS评分及JOA评分比较,差异具有统计学意义(P<0.001),小针刀组及神经阻滞组VAS评分及JOA评分比较差异无统计学意义(P>0.05)。结论:小针刀联合神经阻滞术治疗腰3横突综合症较单纯使用小针刀及单纯神经阻滞术治疗疗效更加显著。

Objective： To observe the clinical effect of using the needle knife surgery combined with sympathetic block for treating third lumbar transverse process syndrome. Methods： All 90 patients with third lumbar transverse process syndrome were divided into the combined group, the needle knife group and the sympathetic block group, 30 cases in each group. The combined group was treated by needle knife surgery plus sympathetic block. The needle knife group was treated by needle knife alone, and the sympathetic group was treated by sympathetic block alone. Rate of clinical effect, visual analogue scale （VAS） and Japanese Orthopaedic Association （JOA） scores were recorded. Results： Total rates of clinical effect in three groups were 96.7 %, 86.7 % and 93.3 % respectively（P〉0.05）. There were no significant difference in three groups of the VAS scores and the JOA scores before the treatment （P〉0.05）. There were significant differences in three groups of the VAS scores and the JOA scores one week after the treatment compared with that of baseline（P〈 0. 001）. Conclusion： The clinical effect of using the needle knife surgery plus nerve block for treating third lumbar trans verse process syndrome is better than that of knife surgery or sympathetic block alone.