X线透视法在腰交感神经节阻滞穿刺中的应用

目的研究X线平片测量法和X线透视法在腰交感神经节穿刺中的到位成功率及其并发症.方法40例拟行L2交感神经节阻滞的腰腿痛病人随机分为两组,每组20例.X线平片测量组（A组）：在病人的X线平片上测量进针的深度和角度后,在L2棘突上缘旁开中线5cm处进针到达预定的深度,然后在X线透视下观察针尖的位置并记录穿刺过程中神经根的刺激情况.X线透视引导组（B组）：在L2棘突上缘旁开中线5 cm处以45度角进针,在X线透视引导下进针至L2椎体的下1/3外侧前缘,记录穿刺过程中神经根的刺激情况.结果（1）B组穿刺到位成功率显著高于A组（P＜0.01）.（2）在穿刺过程中,A组有12例出现神经根刺激症状,而B组仅有4例（P＜0.05）.结论在X线透视引导下进行腰交感神经节阻滞穿刺时,成功率高,并发症少.

Application of lumbar sympathetic ganglion puncture directed by X-ray fluoroscopy

Objective To study the successful puncture rate and complications of lumbar sympathetic ganglion puncture directed by X-ray fluoroscopy.Methods Forty patients with low back and leg pain were randomly divided into two groups with 20 cases each.In group A,the needle was(advanced) in the depth calculated on the base of X-ray films and the needle tip was checked under X-ray fluoroscopy and the complications were recorded.In group B,the needle was advanced directly under the guidance of X-ray fluroscopy and the complications of puncture was recorded as well.Results The successful puncture rate in group B was significantly higher than that in group A(P<0.01).12(patients) in group A had the symptoms of nerve radicle stimulation,but only 4 cases in group B(P<0.05).Conclusion Lumbar sympathetic ganglion puncture directed by Xray fluoroscopy with a higher successful rate and less complications.