超声引导下射频损毁腰脊神经后内侧支治疗对腰椎小关节综合征患者的效果

Effect of ultrasound-guided radiofrequency lesion of posterior medial branch of lumbar spine nerve treatment on patients with lumbar facet joint syndrome

目的探讨超声引导下射频损毁腰脊神经后内侧支治疗对腰椎小关节综合征患者的效果。方法选取2017年2月~2019年2月我院收治的腰椎小关节综合征患者90例,按照治疗方法不同分为两组,对照组行双氯芬酸钠缓释胶囊药物治疗,研究组行超声引导下射频损毁腰脊神经后内侧支治疗。比较两组患者疗效、视觉疼痛模拟评分(VAS)、不良反应情况、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平。结果研究组疗效高于对照组(P<0.05);入院前两组患者VAS评分无明显差异(P>0.05),出院时、治疗后3个月研究组VAS评分低于对照组(P<0.05);研究组总不良反应发生率小于对照组(P<0.05);治疗前两组IL-1β、TNF-α水平相比,无明显差异(P>0.05),治疗后研究组IL-1β、TNF-α水平低于对照组(P<0.05)。结论腰椎小关节综合征治疗中,超声引导下射频损毁腰脊神经后内侧支的疗效显著,可以降低患者疼痛感,改善IL-1β、TNF-α水平,减少不良反应,值得在临床上广泛推广与应用。

Objective To investigate the effect of ultrasound-guided radiofrequency lesion of posterior medial branch of lumbar spine nerve treatment on patients with lumbar facet joint syndrome.Methods A total of 90 patients with lumbar facet joint syndrome admitted to our hospital from February 2017 to February 2019 were enrolled and divided into two groups according to different treatment methods.The control group was given diclofenac sodium sustained-release capsule and the study group was given ultrasound-guided radiofrequency lesion of posterior medial branch of lumbar spine nerve.The efficacy,visual analogue pain scale(VAS),adverse reactions,interleukin-1β(IL-1β)levels and tumor necrosis factor-α(TNF-α)levels of the two groups were compared.Results The efficacy of the study group was superior to that of the control group(P<0.05).There was no significant difference in the VAS score between the two groups before admission(P>0.05).The VAS scores of the study group were lower than those of the control group at the time of discharge and 3 months after treatment(P<0.05).The total incidence of adverse reactions of the study group was lower than that of the control group(P<0.05).There were no significant differences in the IL-1βand TNF-αlevels between the two groups before treatment(P>0.05).The IL-1βand TNF-αlevels of the study group were lower than those of the control group after treatment(P<0.05).Conclusion In the treatment of lumbar facet joint syndrome,the effect of ultrasound-guided radiofrequency ablation of posterior medial branch of lumbar spine nerve is significant,which can reduce the pain of patients,improve the levels of IL-1βand TNF-αand reduce the occurrence of adverse reactions,thereby worthy of clinical promotion and application.