骶管阻滞和联合神经干阻滞治疗腰椎间盘突出症的比较

目的 比较和评价骶管阻滞和骶管阻滞与坐骨神经干阻滞治疗腰椎间盘突出症的临床疗效.方法 腰椎间蕊突出症患者80例随机分成A、B二组,每组40例,分别行骶管阻滞和骶管阻滞联合坐骨神经干阻滞治疗,两组均以曲安奈得、利多卡因、维生素B12、维生素B1与生理盐水混合液行神经阻滞治疗,每周1次,4次为1疗程.结果 经过1个疗程治疗后A、B组的优良率分别为40.0%（16/40例）和82.5%（23/40例）,两组的总有效率分别为65.0%（26/40例）和92.5%（37/40例）,B组疗效明显高于A组（P〈0.01）.A、B二组出现下肢乏力的发生率分别为12.5%（5/40例）和2.5%（1/40例）（P〈0.01）,两组治疗前、后血压均无明显变化（P〉0.05）.结论 骶管阻滞和骶管阻滞联合坐骨神经干阻滞均为治疗腰椎间盘突出症的有效方法,但后者比前者疗效更优,下肢乏力现象更少.

Comparison of sacral block with or without sciatic nerve block for treatment of lumbar intervertebral disc herniation

Objective To compare and evaluate the effects of sacral block and sacral block with sciatic nerve block in the treatment of lumbar intervertebral disc herniation. Methods Eighty adult patients with lumbar intervertebral disc herniation were randomly divided into two groups, forty patients in each. The patients were treated with sacral block in group A and sacral block with sciatic nerve block in group B. The analgesic mixture was composed of triamcinolone acetonide, lidocaine, vitamin B12 , vitamin B1 and normal saline, once a week and four times in one course of treatment. Results After one course of treatment, the total excellent and good rates were 40.0%（16/40 cases） and 82.5%（23/40 cases） and the total effective rate was 65.0%（26/40 cases）and 92.5%（37/40 cases）respectively in group A and group B, the difference was statistical significant（P〈0.01）. The side effect of weakness in lower limbs was 12.5%（5/40 cases）in group A and 2.5%（1/40 cases）in group B（P〈0.01） after treatment, the difference was significant too. There was not significant change of blood pressure in the two groups after the treatment （P〉0.05）. Conclusion The sacral block and sacral block with sciatic nerve block are all effective approaches in the tretment of lumbar intervertebral disc herniation . The effects of the combined two blocks is better than that of sacral block only, with low rate of weakness in lower limbs.