硬膜外注射糖皮质激素治疗腰椎间盘突出症疗效的回顾性分析

摘要

Objective: To assess the therapeutic effects of epidural steroid injection for lumbar intervertebral disk herniation in this retrospective study. Methods: Epidural steroid injections were performed in 62 patients from 2008 to 2009. Forty-four patients with complete follow-up data were included. Therapeutic effects were evaluated 1 day, 1 month and 6 months after treatment. Visual analo-gue scale (VAS) and oswestry disability index (ODI) were assessed. Rusults: VAS and ODI showed statistically significant decrease from initial scores to 1 day and to 1 month (P < 0.05), but not to 6 months (P > 0.05). VAS and ODI showed statistically significant increase from 1 month to 6 months (P < 0.05). Conclusion: Epidural steroid injection may help reduce pain and improve ODI in patients with lumbar intervertebral disk herniation in short periods (1 day and 1 month). The medium- and long-term therapeutic effects (6 months) were poor and the combination with other minimally invasive surgeries was sugsested.%目的:通过对腰椎间盘突出症患者硬膜外注射糖皮质激素疗效的回顾性分析,探讨硬膜外注射对腰椎间盘突出症的短期和中远期疗效.方法:收集我院2008年～2009年62例腰椎间盘突出症并伴有下肢疼痛患者行硬膜外注射糖皮质激素的临床资料.完整随访44例,进行治疗后1天、1月和6月疗效随访调查,并行疗效评价分析.结果:硬膜外注射糖皮质激素后1天、1月视觉模拟评分(visual ananlogue scale,VAS)及Oswestry功能障碍指数(Oswestry disability index,ODI)与治疗前相比显著性降低(P＜0.05),患者治疗后6个月VAS及ODI与治疗前相比无显著性差异(P＞ 0.05).VAS和ODI治疗后6个月与治疗后1个月相比,显著升高.结论:硬膜外注射糖皮质激素对椎间盘突出症有较好的短期(治疗后1天和1月)临床疗效,中长期(治疗后6月)疗效欠佳,建议与其他微创治疗方法联合使用.