平衡针联合关节突浸润麻醉在经皮侧路椎间孔镜手术镇痛中的应用研究

Study on the Application of Balance Acupuncture Combined with Infiltration Anesthesia in Articular Process for Analgesia in Percutaneous Transforaminal Endoscopic Discectomy

目的:探讨平衡针联合关节突浸润麻醉在经皮侧路椎间孔镜手术中镇痛效果与安全性。方法:对本院收治的明确诊断为单一节段腰椎间盘突出症需行经皮侧路椎间孔镜手术的103例患者进行回顾分析。实验组52例,对照组51例,随访时间3~12月,平均10.03月。术中分别以平衡针联合关节突浸润麻醉为超前镇痛干预措施作为实验组,以地佐辛类药物静脉镇痛作对照组,观察术中、术后镇痛效果,评估对比术后疗效及安全性。结果:术后至末次随访时2组患者VAS、JOA评分均较术前改善(P <0.01)。2组治疗后1周、治疗后1月、治疗后末次随访JOA及VAS与治疗前比较,差异有统计学意义(P <0.01)。实验组手术时长少于对照组,组间比较差异有统计学意义(P <0.05)。2组不良反应发生率比较,差异有统计学意义(P <0.01)。结论:围手术期平衡针联合关节突浸润麻醉在经皮侧路椎间孔镜手术中及围手术期可获得满意镇痛效果,同时具备较好安全性。

Objective. To discuss the analgesic effect and safety of balance acupuncture combined with infiltration anesthesia in articular process during percutaneous transforaminal endoscopic discectomy. Methods： Retrospectively analyzed 103 cases of patients in our hospital who were definitely diagnosed with the single segment of the lumbar disc herniation in need of percutaneous transforaminal endoscopic discectomy. Divided them into two groups, 52 cases in the experiment group and 51 cases in the control group. The follow-ups lasted for 3 to 12 months, an average of 10.03 months. During operation, the control group received intravenous analgesia with dezocine-type drugs, while the experiment group received balance acupuncture combined with infiltration anesthesia in articular process as the intervening measures of preemptive analgesia. Observed the analgesic effect during and after operation, evaluated and compared the postoperative clinical effect and safety. Results： After operation to the last time of follow-ups, VAS and JOA scores in both groups were improved when comparing with those before operation （P 〈 0.01）. Comparing JOA and VAS scores in both groups after treatment for one week, one month and the last time of follow-ups with those before treatment, there were significant differences being found（P 〈 0.01）. The operation time in the experiment group was shorter than that in the control group, difference being significant（P 〈 0.05）. Comparing the incidence of adverse reactions in both groups, there were significant difference being found（P 〈 0.01）. Conclusion： Balance acupuncture combined with infiltration anesthesia in articular process has satisfactory analgesic effect and relatively good safety during percutaneous transforaminal endoscopic discectomy and perioperative period.