交感神经阻滞联合药物治疗骨质疏松脊柱压缩性骨折患者疼痛的疗效

Efficacy of sympathetic nerve block combined with drugs therapy treatment of osteoporosis compression fracture pain

目的观察交感神经神经阻滞联合药物治疗骨质疏松脊柱压缩性骨折患者疼痛的效果。方法收集乌鲁木齐市友谊医院疼痛科骨质疏松脊柱压缩性骨折患者86例,将患者随机分为两组,交感神经阻滞联合抗骨质疏松治疗A组44例,口服药物B组42例。于治疗前及治疗后1 d、1周、1个月、6个月时采用疼痛强度及腰背功能评分进行评估,治疗后6个月评价治疗效果,观察并记录两组腰背活动时疼痛缓解所需时间。结果治疗组优效、良效、可转、无效依次为63.6%(28/44例)、27.3%(12/44例)、4.5%(2/44例)、4.5%(2/44例);对照组依次为35.7%(15/42例)、23.8%(10/42例)、21.4%(9/42例)、19.0%(8/42例),治疗前两组疼痛及腰背功能评分差异无统计学意义(P>0.05)。治疗后1d、1周、1月、6个月两组疼痛及要背功能评分均下降明显,A组优于B组(P<0.01);腰背疼痛缓解时间A组短于B组,A组更快达到治疗效果。结论交感神经阻滞联合药物疗法能明显改善骨质疏松脊柱压缩性骨折患者疼痛症状,改善腰背功能,优于双氯芬酸钠加抗骨质疏松药物疗法。

Objective To observe the effect of sympathetic nerve block combined with drugs on the pain of osteoporotic spine compression fractures.Methods 86 patients with osteoporotic spinal compression fractures from the Pain Department of Urumqi Friendship Hospital were randomly divided into two groups.The 44 cases A group were treatedwith sympathetic nerveblock combined with anti-osteoporosis treatment while 42 cases B group were treated with oral diclofenac and anti-osteoporosis treatment.Before treatment and treatment 1 day,1 week,and 1 month,6 months after treatment,the pain intensity and lower back function scores were evaluated.The treatment effect was evaluated 6 months after treatment,observing and recording the time required for pain relief of during low back movement in both groups.Results The significantly effective,effective,improved,and ineffective results in order in the treatment group were 63.6%(28/44 cases),27.3%(12/44 cases),4.5%(2/44 cases),4.5%(2/44 cases);the same in order the control group were 35.7%(15/42 cases),23.8%(10/42 cases),21.4%(9/42 cases),19.0%(8/42 cases).There was no statistically significant difference in the scores of pains and lower back function(P>0.05)before treatment.The pain scores and the lower back function scores of both groups decreased significantly at 1 day,1 week,and 1 month,6 month after treatment,and A group better than B group(P<0.01);the relief time of lower back pain in A group was shorter than that B group,and A group achieved the treatment effect faster.Conclusions Sympathetic nerve block combined with drug therapy can significantly improve the pain symptom of patients with osteoporotic spine compression fractures and improve the function of the lower back which is superior to oral diclofenac and anti-osteoporosis treatment.