改良法腰交感神经节毁损术治疗下肢血栓闭塞性脉管炎的可行性

目的探索数字减影机引导下以无水乙醇行L2交感神经节毁损术治疗血栓闭塞性脉管炎的可行性。方法血栓闭塞性脉管炎患者48例，随机分为2组，改良法L2交感神经节毁损组（试验组）和传统的化学性腰交感神经节毁损组（对照组），每组24例，试验组行L2交感神经节阻滞取代两节或多节传统的无水乙醇阻滞，并使针尖置于L2～3椎间盘前外侧缘而非传统方法的椎体中间，对照组则用传统方法行L2、L3交感神经节毁损，两组患者治疗前后进行VAS、临床疗效、术中参数及并发症的比较。结果术后两组患者疼痛均明显缓解，临床疗效均较好，两组比较无统计学差异，但试验组较对照组操作省时，毁损药量少、接触X线时间短，并发症少。结论L2交感神经节毁损术治疗血栓闭塞性脉管炎是一种安全有效、简单易行的方法。

Feasibility of modified lumbar sympathetic ganglion neurolytic block for treating thromboangitis obliterans

Objective To explore the feasibility of modified neurolytic block of lumbar sympathetic ganglion guided by DSA with alcohol for treating thromboangitis obliterans （TAO） and compare with traditional method. Methods Forty- eight patients with TAO were divided randomly into two groups： testing group and control group, 24 patients in each. Neurolytic block of second lumbar sympathetic ganglion was performed instead of two or more ganglia blocks of traditional lumbar sympathetic ganglia in testing group. The target of the needle tip was in the anterior- lateral margin of the L2-3 intervertebral space. Chemical lumbar sympathectomy of second and third lumbar ganglia were performed in traditional method in control group. VAS , therapeutic effect, parameters during the opertations and the incidence of complications during and after operations were compared between the two groups before and after treatment. Results After the operations, pain relief in the two group was similar and significantly, there was no obvious difference （P〉0.05）. But the operation time,the volume of alcohol for neurolytic block, the doses of X-ray contacted with doctor and patient,the complications assoiated with operations were less in testing group than those in control group （P〈0.05）. Conclusion Modified neurolytic block via second sympathetic ganglion is a simpler, safer , more feasible and effective approach for treating TAO than the traditional method.