胸脊神經射頻熱凝治療胸椎壓縮骨折后肋間神經痛的臨床觀察

林立鈞

【摘要】 目的：探討胸脊神經射頻熱凝治療胸椎壓縮骨折后肋間神經痛的臨床效果。方法：采用隨機數字表法在筆者所在醫院2017年1月-2018年6月收治的胸椎壓縮骨折后肋間神經痛患者中納入58例為對象，用單盲法將58例患者分為對照組和觀察組，各29例。對照組患者采用常規方法治療，而觀察組患者采用胸脊神經射頻熱凝術治療。結果：治療前兩組患者VAS評分、ODI指數、QOL評分比較差異均無統計學意義（P>0.05）;治療后各時間段兩組患者VAS評分、ODI指數均降低，QOL評分均升高，且觀察組患者VAS評分、ODI指數低于對照組，QOL評分高于對照組，差異均有統計學意義（P<0.05）。結論：胸脊神經射頻熱凝治療胸椎壓縮骨折后肋間神經痛的臨床效果明顯，具有多方面應用優勢。

【關鍵詞】 胸椎壓縮骨折; 肋間神經痛; 胸脊神經射頻熱凝; 效果

doi：10.14033/j.cnki.cfmr.2019.17.016 文獻標識碼 B 文章編號 1674-6805（2019）17-00-03

【Abstract】 Objective：To investigate the clinical effect of radiofrequency thermocoagulation of thoracic spinal nerve on intercostal neuralgia after thoracic vertebral compression fracture.Method：A total of 58 patients with intercostal neuralgia after thoracic vertebral compression fracture in our hospital from January 2017 to June 2018 were enrolled.The 58 patients were divided into the control group and the observation group by single blind method，29 cases in each group.The patients in the control group were treated with routine methods，while those in the observation group were treated with radiofrequency thermocoagulation of thoracic spinal nerve.Result：There was no significant difference in VAS score，ODI index and QOL score between the two groups before treatment（P>0.05）.After treatment，the VAS score and ODI index were decreased and the QOL score was increased in both groups，and the VAS score and ODI index of the observation group were lower than those of the control group，and the QOL score of the observation group was significantly higher than that of the control group（P<0.05）.Conclusion：Radiofrequency thermocoagulation of thoracic spinal nerve is effective in treating intercostal neuralgia after thoracic vertebral compression fracture，and has many advantages.

【Key words】 Thoracic vertebral compression fracture; Intercostal neuralgia; Radiofrequency thermocoagulation of thoracic spinal nerve; Effect

First-authors address：Baoshan Peoples Hospital，Baoshan 678000，China

目前，臨床上可治療肋間神經痛的手段較多，但用于治療胸椎壓縮骨折后肋間神經痛患者的有效性和安全性參差不齊，本次研究旨在對胸椎壓縮骨折后肋間神經痛患者采用胸脊神經射頻熱凝治療的臨床效果作探討，以期為臨床實際應用提供參考，具體如下。

1 資料與方法

1.1 一般資料

采用隨機數字表法在筆者所在醫院2017年1月-2018年6月收治的胸椎壓縮骨折后肋間神經痛患者中納入58例為對象，納入患者病情均采用影像學診斷證實，具有典型的臨床癥狀，包括胸背部串電樣疼痛感強烈，且疼痛大都放射到前胸部位，變換體位后會加重疼痛感，疼痛持續時間>3個月[1];排除合并下肢肌力障礙或大小便障礙等脊髓受損癥狀的患者，具有凝血功能異常和重大臟器（心、肝、腎等）疾病、精神障礙的患者，以及機體不能耐受手術或者臨床資料不完善的患者。用單盲法將58例患者分為對照組和觀察組，各29例，對照組患者中男18例，女11例，年齡52～78歲，平均（65.97±5.73）歲;觀察組患者中男19例，女10例，年齡53～79歲，平均（65.80±5.76）歲。兩組基礎資料比較，差異無統計學意義（P>0.05），具有可比性。本次研究中涉及的內容均未違背醫學倫理，醫院倫理委員會批準實施，征得患者的同意，簽署知情同意書。