椎旁神经根阻滞治疗腰椎管狭窄症的疗效

Efficacy of paravertebral nerve root block in the treatment of patients with lumber spinal stenosis

目的探讨神经根阻滞疗法治疗腰椎管狭窄症的安全性及临床效果。方法选择轻至中度症状的腰椎管狭窄症患者80例，随机分为两组，每组40例。其中口服药物组给予双氯芬酸钠缓释胶囊，50mg／次，口服，2次，d，服用2周；甲钴胺片，0．5mg口服，3次，d，服用1个月；阻滞组每周椎旁神经根阻滞治疗1次，3次为1个疗程。治疗前及治疗后4个月时随访，随访时行VAS评分及行走改善情况记录比较。结果两组患者治疗前VAS评分及步行距离差异无统计学意义（P〉0．05）；与治疗前比较，两组患者治疗后VAS评分及步行距离均得到改善，且阻滞组改善更明显，差异均有统计学意义（P〈0．05）。两组患者均未见严重不良反应。结论椎旁神经根阻滞疗法治疗腰椎管狭窄症安全有效。

Objective To explore the safety and efficacy of the nerve root block therapy in the treatment of patients with lumbar spinal stenosis. Methods Eighty patients with mild to moderate symptoms of lumbar spinal stenosis were randomly divided into two groups, 40 cases in each group. Patients in oral medication group were given diclofenac sodium sustained-release capsules, 50 rag/time, 2 times/day, 2 weeks; mecobalamin tablets, 0.5 mg/time, 3 times/day, one month; Block group were given weekly paravertebral nerve root block, 3 times for one course of treatment. Before and 4 months after the treatment, the VAS and self-paced walking test were recorded and compared. Results The VAS and walking distance had no statistical difference in the two groups before treatment （P 〉 0.05）; Compared with pretreatment, the VAS and walking distance in the two groups were all improved after treatment, the patients in block group were more improved, which were of statistical significance （P〈 0.05）. The serious adverse reactions were not seen in all patients. Conclusion Paravertebral nerve roots block is safe and effective in the treatment of patients with lumber spinal stenosis.