超声引导下亚甲蓝神经阻滞治疗腰脊神经后支综合征患者的临床研究

Methylene blue nerve block guided by ultrasound for patients with syndrome of the posterior ramus of lumbar spinal nerve

目的探讨超声引导下亚甲蓝神经阻滞治疗腰脊神经后支综合征的临床疗效。方法收集2017年2月至2018年10月就诊于滨州医学院附属医院疼痛科的腰脊神经后支综合征患者76例,性别不限,年龄34~65岁,按照随机数字表法随机分为亚甲蓝阻滞组和常规阻滞组,每组38例。常规阻滞组采用利多卡因、曲安奈德进行神经阻滞,亚甲蓝阻滞组采用利多卡因、曲安奈德和亚甲蓝进行神经阻滞。评价治疗前及治疗后1、3、6个月时视觉模拟评分(VAS)及术后6个月时疼痛缓解有效率。结果治疗后1、3、6个月时亚甲蓝阻滞组VAS评分和术后6个月时疼痛缓解有效率均明显优于常规阻滞组(1.18±0.93比3.31±1.40,1.21±0.84比3.18±1.23,1.13±0.81比3.34±1.26,94.7%比78.9%,P均<0.05)。结论超声引导下亚甲蓝神经阻滞治疗腰脊神经后支综合征安全、有效。

Objective To investigate the clinical efficacy of methylene blue nerve block guided by ultrasound in the treatment of patients with syndrome of the posterior ramus of lumbar spinal nerve. Methods Seventy-six patients with syndrome of the posterior ramus of lumbar spinal nerve, both sexes, 34-65 years old, from February 2017 to October 2018 in Binzhou Medical College Hospital, were randomly divided into methylene blue nerve block group and conventional nerve block group according to random number table method, 38 cases in each group. Lidocaine and triamcinolone acetonide were injected for nerve block in conventional nerve block group, while lidocaine, triamcinolone acetonide and methylene blue in methylene blue nerve block group. Visual analogue scale (VAS) was observed before the treatment and at 1, 3 and 6 months after the treatment, and effective pain relief rate was also observed at 6 months after the treatment. Results The VAS was significantly lower at 1, 3 and 6 months after the treatment in methylene blue nerve block group than that in conventional nerve block group (1.18±0.93 vs. 3.31±1.40, 1.21±0.84 vs. 3.18±1.23, 1.13±0.81 vs. 3.34±1.26, all P<0.05). The effective pain relief rate was higher at 6 months after the treatment in methylene blue nerve block group than that in conventional nerve block group (94.7% vs. 78.9%, P<0.05). Conclusion Ultrasound-guided methylene blue spinal nerve block is safe and effective in the treatment of patients with syndrome of the posterior ramus of lumbar spinal nerve.