DSA引导针刀闭合松解术治疗神经根型颈椎病的临床研究

Clinical Research on the Treatment of Nervous Root Type Cervical Spondylotic Disease with DSA-Guided Needle-Knife Closed-Release Therapy

目的:评价数字减影血管造影(DSA)引导针刀闭合松解术治疗神经根型颈椎病的临床疗效和安全性。方法:选择神经根型颈椎病患者60例,按随机数字表法随机分为治疗组(DSA引导针刀组,n=30)和对照组(传统针刀组,n=30),两组均每周治疗1次,2次为1个疗程。比较术前和术后2h、1周、2周、4周的VAS评分情况及总体疗效情况,观察两组针刀操作的准确率及不良反应发生率。结果:治疗组患者在治疗后2h、1周、2周及4周的VAS评分明显优于对照组,治疗组总显效率优于对照组,对照组患者不良反应发生率为13.33%,明显高于治疗组患者的0%,差异均有统计学意义(P<0.05)。治疗组共有24例患者在治疗中针刀刀刃位置需要调整,占治疗组病例数的80.0%。结论:DSA引导针刀闭合松解术治疗神经根型颈椎病的临床疗效优于传统针刀治疗,且准确性高,安全性好。

Objective:To evaluate the clinical effect and safety of the needle-knife closed-release therapy under DSA guidance for the nervous root type cervical spondylotic disease.Methods:We chose 60 cases of the patients with the nervous root type cervical spondylotic disease,and randomly divided the patients into the treatment group (needle-knife closed-release therapy under DSA guidance group,n=30) and the control group (traditional needle-knife group,n=30).Both group were treated once a week,and twice treatment as one course. And then,we compared VAS scores and total apparent efficiency before and after treatment for two hours,one week,two weeks and four weeks;And the accuracy rate and the incident of adverse reactions rate were observed in the two groups.Results:The VAS scores of the study group was significantly better than that of the control group at 2 hours,1 weeks,2 weeks and 4 weeks after treatment.The total effective rate of the study group was significantly better than that of the control group.The incidence rate of adverse reactions in the control group (13.33%) was significantly higher than that in the treatment group (0%).And the above differences were statistically significant (P<0.05).A total of 24 patients in the treatment group needed to adjust the knife edge position during the treatment,accounting for 80.0% of the total number of cases in the treatment group. Conclusion:The treatment of nervous root type cervical spondylotic disease with DSA guided needle -knife closed-release therapy is better than with the traditional needle-knife therapy.And it has the advantages of high accuracy and good safety,and is worthy of clinical promotion.