脊神经后支阻滞对急性腰椎体压缩骨折成形术后残留疼痛效果的临床研究

Clinical research on residual pain effect of dorsal spinal radicle block after the plasty of acute lumbar vertebral compression fracture

目的探讨脊神经后支阻滞对急性腰椎体压缩骨折成形术后残留疼痛的临床效果。方法选取2015年8月~2017年8月在我院接受急性腰椎体压缩骨折成形术治疗的92例患者作为研究对象,通过随机分组的形式,将其分为对照组和研究组,每组各46例。对照组采用非甾体类消炎镇痛药物对术后残留疼痛进行干预;研究组采用脊神经后支阻滞方式对术后残留疼痛进行干预。结果研究组患者在术后止痛干预前后疼痛程度VAS评分和OSWESTRY功能障碍指数水平的改善幅度大于对照组,差异有统计学意义(P<0.05);研究组患者对急性腰椎体压缩骨折成形术后残留疼痛控制治疗方案及效果的满意度(93.5%)高于对照组(78.3%),差异有统计学意义(P<0.05);观察组患者术后疼痛消失时间和住院治疗总时间短于对照组,差异有统计学意义(P<0.05);观察组患者术后由于疼痛导致的不良情绪和睡眠障碍发生率低于对照组(P<0.05);观察组患者术后处残留疼痛控制的总有效率(91.3%)优于对照组(71.7%),差异有统计学意义(P<0.05)。结论接受急性腰椎体压缩骨折成形术治疗的患者采用脊神经后支阻滞干预,可以有效减轻术后残留疼痛,在短时间内控制症状,缩短术后治疗时间,防止不良情绪及睡眠障碍的产生,显著提高疼痛控制效果和患者的满意度。

Objective To explore the clinical effect of dorsal spinal radicle block on alleviating postoperative residual pain in patients undergone the plasty of acute lumbar vertebral compression fracture.Methods From August 2015 to August 2017,92 patients undergone the plasty of acute lumbar vertebral compression fracture were selected as the subjects,and evenly divided into control group and research group in random,46 cases in each group.In the control group,nonsteroidal anti-inflammatory analgesic drugs were used for the intervention of residual pain after operation.In the research group,dorsal spinal radicle block was applied as an intervention.Results In the research group,the improvement of VAS score and Oswestry disability index before and after pain intervention was greater than that in the control group,the difference was statistically significant （P〈O.05）.The satisfaction on therapeutic regimen and effect of residual pain control after the plasty of acute lumbar spine compression fracture in the research group （93.5%） was higher in the control group （78.3%）,the difference was statistically significant （P〈0.05）.The disappearing time of postoperative pain and total hospital stay in the research group were shorter than those in the control group,the difference was statistically significant （P〈0.05）.The rate of cases occurred with bad emotions and sleep disorder due to pain after surgery in the research group was lower than that in the control group （P〈0.05）.The total effectiveness rate of residual pain control after surgery in the research group （91.3%） was better than that in the control group （71.7%）,the difference was statistically significant （P〈0.05）.Conelusion For patients undergone the plasty of acute lumbar vertebral compression fracture,dorsal spinal radicle block as an intervention can effectively alleviate postoperative residual pain,control the symptom in a short time,shorten the therapeutic time after surgery,and prevent the occurrence of bad emotions and sleep disorder,improve the control effect of pain and patient＇s satisfaction.