电针联合镇痛药物对腰椎管狭窄症术后镇痛的影响

Effect of Electroacupuncture plus Analgesics on Analgesia After Surgery for Lumbar Spinal Stenosis

目的观察电针联合镇痛药物对腰椎管狭窄症改良经椎间孔腰椎椎体间融合术(TLIF)术后镇痛的作用。方法选择腰椎改良TLIF术后患者62例,随机分为试验组和对照组,每组31例。对照组术后采用镇痛药物镇痛,试验组在对照组镇痛基础上电针承山、委中穴镇痛。观察比较两组术前、术后24 h、术后48 h及术后1周腰椎的视觉模拟量表(VAS)及日本骨科协会(JOA)评分,比较术后1周两组患者腰背伸高度,并比较两组术后追加镇痛药物使用情况。结果两组术后腰椎VAS及JOA评分优于术前(P<0.05)。试验组术后48 h腰椎VAS评分优于对照组(P<0.05);术后48 h两组腰椎JOA评分比较,差异无统计学意义(P>0.05);术后1周试验组VAS、JOA评分以及腰背伸高度均优于对照组(P<0.05)。两组在观察期内均未见不良事件;两组术后追加镇痛药物使用率比较,差异无统计学意义(P>0.05)。结论电针联合镇痛药物可以减轻患者术后腰部疼痛,临床应用安全有效。

Objective To observe the effect of electroacupuncture plus analgesics on analgesia after modified transforaminal lumbar interbody fusion(TLIF)for lumbar spinal stenosis.Method Sixty-two patients with modified TLIF on lumbar vertebrae were randomized to experimental and control groups,with 31 cases in each group.After surgery,the control group took analgesics and the experimental group received electroacupuncture at points Chengshan and Weizhong in addition.The visual analog score(VAS)scores and the Japanese Orthopeadic Association(JOA)scores were compared between the two groups before surgery and at 24 hrs,48 hrs and one week after.Low back extension height was compared between the two groups of patients at one week after surgery.Postoperative additional analgesic dosage was compared between the two groups.Result After surgery,the VAS and JOA scores for lumbar vertebrae were better in the two groups compared with before(P<0.05).At 48 hrs after surgery,the VAS score for lumbar vertebrae was better in the experimental group than in the control group(P<0.05)and the JOA score for lumbar vertebrae had no statistically significant difference between the two groups(P>0.05).At one week after surgery,the VAS and JOA scores and low back extension height were better in the experimental group than in the control group(P<0.05).No adverse reaction occurred in both groups during the observation period.The postoperative use rates of additional analgesics had no statistically significant difference between the two groups(P>0.05).Conclusion Electroacupuncture plus analgesics can relieve postoperative pain in the patients.Its clinical application is safe and effective.