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目的:观察硬膜外类固醇注射联合小针刀微创黄韧带松解术治疗腰椎滑脱症的临床疗效。方法:88例腰椎滑脱症患者依治疗方法不同分为A,B2组各44例,B组采用针灸理疗、牵引手法复位、中药内服及外用熏蒸等综合治疗;A组在综合治疗基础上给予硬膜外类固醇复合镇痛液注射联合小针刀黄韧带松解术治疗。比较2组治疗前、后疼痛VAS评分、腰椎滑脱指数及疗效。结果:A组优22例,良12例,有效7例,治愈率77.27%;B组优12例,良10例,有效14例,治愈率50.00%,2组比较差异有统计学意义(P<0.05)。2组治疗前、后各项腰椎滑脱指数比较差异无统计学意义(P>0.05)。2组治疗后2,4,7,14d,3个月疼痛VAS评分均较治疗前降低(P<0.05),B组治疗2,4,7dVAS评分高于A组(P<0.05或P<0.01),14d后比较差异无统计学意义(P>0.05)。结论:硬膜外类固醇复合镇痛液注射联合小针刀微创黄韧带松解术是非手术治疗腰椎滑脱症的有效方法之一。
Objective: To observe the clinical effect of epidural steroid injection combined with a small needle minimally invasive ligamentum flavum in the treatment of lumbar spondylolisthesis. Methods: Eighty-eight patients with spondylolisthesis were divided into two groups according to the different treatment methods: 44 cases in group A and B2, group B in acupuncture and moxibustion, reduction in traction, internal and external use of traditional Chinese medicine fumigation and other comprehensive treatment; Extracapsular Steroid Combination Analgesic Injection Combined with Small Needle Ligamentum Ligament Loosening. VAS score, lumbar spondylolisthesis index and curative effect were compared between two groups before and after treatment. Results: A group of 22 cases excellent, good in 12 cases, effective in 7 cases, the cure rate was 77.27%; B group was excellent in 12 cases, good in 10 cases and effective in 14 cases, the cure rate was 50.00%. There was significant difference between the two groups (P <0.05). There was no significant difference in the lumbar spondylolisthesis index between the two groups before and after treatment (P> 0.05). VAS scores of pain relief in 2 groups at 2, 4, 7, 14 and 3 months after treatment were lower than those before treatment (P <0.05), while VAS scores at 2, 4 and 7 days in group B were higher than those in group A (P <0.05 or P <0.01) ), There was no significant difference after 14 days (P> 0.05). Conclusion: Epidural steroid combined analgesic injection with a small needle minimally invasive ligamentum flavum is an effective non-surgical treatment of lumbar spondylosis one of the ways.