作　　者： (徐昆）; (郝佳颖）; (肖天洁）; (杜元良）; (孙贺）; (王建华）; (刘正蓬）; (孙志杰）; (赵艳军）; (张峥）;

机构地区： 承德医学院附属医院,河北承德067000

出　　处： 《河北医学》 2017年第8期1272-1275,共4页

摘　　要： 目的:探讨臀上、臀中皮神经松解联合神经妥乐平封闭治疗LDH(腰椎间盘突出症)术后残余神经痛的临床疗效。方法:选择年龄40~59岁的LDH患者90例(男女各45例)经正规保守治疗4周无效且VAS≥5分患者,行腰4~5或腰5-骶1髓核摘除、椎间融合术后第2周仍存在下肢疼痛或(和)麻木者,按照完全随机等分法分三组、每组30例:A组(对照组),B组(骶管封闭组),C组(臀上、臀中皮神经松解联合神经妥乐平封闭组),通过上述三组治疗24周后,观察C组治疗LDH术后残余神经痛的临床疗效及VAS、JOA评分、临床改善率。结果:C组(臀上、臀中皮神经松解联合神经妥乐平封闭组)临床疗效及VAS、JOA评分、临床改善率显著优于A、B两组,差异具有统计学意义(P<0.05)。结论:臀上、臀中皮神经松解联合神经妥乐平封闭治疗可显著改善LDH术后残余神经痛症状,缓解临床患者痛苦,具有显著的临床疗效及治疗意义。 Objective： To observe the clinical curative effect of superior and middle gluteal nerve neurolysis combining with neurotropin close treatment for LDH（ protrusion of lumbar intervertebral disc） postoperative remaining nerve neuralgia. Methods： 90 LDH cases of the age between 40 ~ 59 years old（ 45 female cases and 45 male cases） who were insensitive to four weeks of regular conservative treatment,VAS 5 and still got lower limb pain or（ and） numbness at the second week after undergoing waist 4 ~ 5 or waist 5-sacrum 1 removal of nucleus pulposus,intervertebral fusion surgery were randomly divided into three groups,30 cases in each group： group A（ testing control group）,group B（ shinbone tube seal）,group C（ superior and middle gluteal nerve neurolysis combining with neurotropin close treatment）. After 24 weeks of treatment,observed the clinical curative effect of group C treating LDH postoperative remaining nerve neuralgia and VAS,JOA,clinical periodscore. Results： The clinical curative effect and VAS,JOA,Clinical periodscore score of group C（ superior and middle gluteal nerve neurolysis combining with neurotropin close treatment） were significantly better than that of group A and group B,the differences was statistically significant（ P〈0. 05）. Conclusion：Superior and middle gluteal nerve neurolysis combining with neurotropin close treatment can significantly relieve symptoms of LDH postoperative remaining nerve neuralgia and reduce patients＇ clinical pain,so it is of significant clinical curative effect and treatment significance.

关 键 词： 腰椎融合术 残余神经痛 神经卡压 神经妥乐平 骶管封闭