超声引导辅助CT定位用于腰交感神经节阻滞穿刺的临床分析

Clinical Analysis of Ultrasound-guided CT Localization for Lumbar Sympathetic Ganglion Block Puncture

目的观察超声引导辅助CT定位用于腰交感神经节阻滞穿刺的临床效果。方法选取2019年12月—2020年11月于宁津县人民医院进行腰交感神经节阻滞的180例患者,按随机数表法将其分为A组(60例)、B组(60例)、C组(60例)。A组采用超声定位腰交感神经节阻滞,B组采用CT定位腰交感神经节阻滞,C组则采用超声引导辅助CT定位腰交感神经节阻滞。统计3组穿刺针调整次数、操作时间、足底皮肤温度、疼痛程度。结果C组穿刺针调整次数为(0.74±0.35)次,少于A组、B组,A组穿刺针调整次数少于B组;C组操作时间为(18.92±3.17)min,短于A组、B组,A组操作时间短于B组,差异有统计学意义(F=73.966、78.543,P<0.05);阻滞前3组足底皮肤温度、VAS评分对比,差异无统计学意义(P>0.05);阻滞后7 d,C组足底皮肤温度为(36.21±0.99)℃,高于A组、B组,A组足底皮肤温度高于B组;C组VAS评分为(2.03±0.55)分,低于A组、B组,A组,差异有统计学意义(F=50.244、35.254,P<0.05)。结论超声引导辅助CT定位用于腰交感神经节阻滞中安全可行,能够提供实时直观的影像学依据,缩短操作时间,提高穿刺成功率,提高阻滞效果。

Objective To observe the clinical effect of ultrasound-guided CT positioning for lumbar sympathetic ganglion puncture.Methods 180 patients who underwent lumbar sympathetic ganglion block poncture in Ningjin County People's Hospital from December 2019 to November 2020 were selected and divided into group A(60 cases)and group B(60 cases)and group C(60 cases)according to the random number table method.Group A used ultrasound to locate the lumbar sympathetic ganglion block,group B used CT to locate the lumbar sympathetic ganglion block,and group C used ultrasound-assisted CT to locate the lumbar sympathetic ganglion block.The three groups of puncture needle adjustment times,operation time,plantar skin temperature,and pain degree were counted.Results The number of puncture needle adjustments in group C was(0.74±0.35)times,which was less than that of groups A and B.The number of puncture needle adjustments in group A was less than that in group B.The operating time of group C was(18.92±3.17)min,which was shorter than that of groups A and B.The operating time of group A was shorter than that of group B,the difference was statistically significant(F=73.966,78.543,P<0.05).There was no statistically significant difference in plantar skin temperature and VAS score between the three groups before the block(P>0.05).After 7 d of retardation,the plantar skin temperature of group C was(36.21±0.99)℃,which was higher than that of groups A and B,and the plantar skin temperature of group A was higher than that of group B.The VAS score of group C was(2.03±0.55)points,which was lower than that of group A,group B,and group A,the difference was statistically significant(F=50.244,35.254,P<0.05).Conclusion Ultrasound-guided CT positioning is safe and feasible for lumbar sympathetic ganglion block.It can provide real-time and intuitive imaging basis,shorten the operation time,increase the success rate of puncture,and improve the block effect.