DSA引导下选择性脊神经根阻滞对腰椎间盘突出症临床疗效分析

目的：分析DSA引导下选择性脊神经根阻滞对腰椎间盘突出症，临床疗效。方法：将86例腰椎间盘突出症患者随机均分为SNRB组及PVB组。SNRB组患者采用DSA引导下选择性脊神经根阻滞。PVB组采用腰椎旁神经阻滞。对比两组患者用药、治疗前及治疗7d、14d时VAS评分、治疗7d及治疗14d时疗效及不良反应。结果：SNRB组患者在局麻药及得宝松用量上均明显低于PVB组（P〈0．01）。SNRB需加用口服镇痛药比例（6．98％）明显低于PVB（32．56％）（P〈0．01）。治疗7d及14d时，SNRB组VAS分值均明显低于PVB组（P〈0．01）。治疗7d后，SNRB组治疗总有效率达79．07％，明显高于PVB组总有效率（55．81％）（P〈0．05）；治疗14d后，SNRB组总有效率达95_35％，明显高于PVB组（74．42％）（P〈0．01）。SNRB组不良反应发生率为4．65％。PVB组不良反应发生率为18．60％。PVB组不良反应发生率高于SNRB组（P〈0．05）。结论：DSA引导下选择性脊神经根阻滞具有阻滞用药少，阻滞效果更好，作用准确及安全的优点。

Clinical Effect Analyse of the Selective Spinal Nerve Root Block under DSA Guidance for the Lumbar Disc Herniation

Objective： To analyze the clinical effect of the selective spinal nerve root block trader DSA guidance for the lumbar disc herniation. Methods： 86 cases with lumbar disc herniation（LDH） were divided randomly into the SNRB and PVB averagely. The pa- tients in SNRB were taken selective spinal nerve root block under DSA guidance when the patients in PVB were taken para vertebral nerve block. The drng-use, VAS scores before 7 d and 14 d after the treatment, clinical effect after 7 d and 14 d treatment and the adverse reaction between the two group were compared. Results： The dose of local anesthetics and diprospan in the SNRB were obviously less than those in the PVB （P〈0.01）. The rate of the patients who needed adding oral analgesics in the SNRB （6.98%） was lower than that in the PVB （32.56%）（P〈0.01）. The VAS scores after 7 d and 14 d treatment in the SNRB were both lower than those scores in the PVB （P〈0.01）. After 7 d treatment, the total effective rate in the SNRB was 79.07%, which was obviously higher than 55.81% in the PVB（P〈0. 01）. After 14 d treatment, the total effective rate in the SNRB （95.35%） was higher than that in the PVB （74.42%）（P〈0.01）. The adverse reaction rate in the SNRB was 4.65% when that n the PVB was18.60%, and the rate in the PVB was higher than that in SNRB（P〈0.01）. Conclusion： Selected spinal nerve root block under the DSA guidance showed the advantage of less dose of blocking drug, better block- ing effect, blocking in precision and safety.