多普勒引导下骶髂关节腔注射可行性研究

中国临床药理学与治疗学 ›› 2007, Vol. 12 ›› Issue (1): 111-115.

多普勒引导下骶髂关节腔注射可行性研究

蒋峰¹, 梅艳², 费忆力⁵, 邵立民⁴, 姚晨⁶, 邵永良³, 史佳¹

¹浙湖州第三人民医院风湿免疫科, ²彩超室, ³放射科, ⁴骨科, 湖州 313000, 浙江;
⁵湖州中医院麻醉科, 湖州 313000, 浙江;
⁶北京大学第一医院统计教研室, 北京 100153

收稿日期:2006-08-29 修回日期:2006-10-28 出版日期:2007-01-26 发布日期:2020-10-26
作者简介:蒋峰, 男, 学士, 副主任医生, 研究方向:脊柱关节病发病机制及治疗方法。Tel:13757289076 E-mail:SXF1153@126.com

Feasible study on sacroiliac joint internal injection performed under Doppler guidance

JIANG Feng¹, MEI Yan², FEI Yi-li⁵, SHAO Li-min⁴, YAO Chen⁶, SHAO Yong-liang³, SHI Jia¹

¹Department of Rheumatology and Immunology, ²Department of Doppler, ³X-ray Department, ⁴Department of Orthopaedics, the Third Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
⁵Department of Anesthesiology, Traditional Chinese Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
⁶Statistic Department, the First Hospital of Beijing University, Beijing 100153, China

Received:2006-08-29 Revised:2006-10-28 Online:2007-01-26 Published:2020-10-26

摘要/Abstract

摘要： 目的: 探索多普勒引导下骶髂关节腔内注射复方倍他米松的技术, 治疗Ⅱ ~ Ⅲ级骶髂关节炎的可行性、安全性, 并进行疗效对比研究。方法: 71 例骶髂关节炎患者, 随机分为3 组:多普勒组(DP 组)24 例, CT 组23 例, 对照组24 例。按不同的引导方式对骶髂关节进行注射复方倍他米松注射液(7 mg/mL) 治疗, 并与同期非注射治疗组进行90 d随访观察。观察内容:Bath 疾病活动指数(DASDAI)、脊柱活动度测量学指数(BASMI) 、功能指数(BASFI), 同时测量指地距、4 字试验(Patrick test) 和骶髂关节压迫试验的目测模拟疼痛标尺(VAS) 评分。结果: DP 、CT 组与对照组比较, DASDAI 、BASMI、BASFI 及4 字试验、骶髂关节压迫试验在治疗后1 、7 、30 d 差异有统计学意义(P<0.05);治疗后1 、7 、30 d指地距比较差异有统计学意义(P<0.05);90 d随访观察中DP 组与CT 组组间比较差异无统计学意义。穿刺治疗的47 例中,DP 组2 例、CT 组1 例穿刺失败, 发生率分别为8.3 %和4.6 %(P ≥0.05);CT 组、对照组各1 例复查实验室异常中止观察;DP 组、CT 组各1 例, 对照组2 例失访。结论: 骶髂关节腔注射复方倍他米松是治疗Ⅱ ~ Ⅲ组骶髂关节炎的可行方法, 具有安全性好、起效时间短、疗效确切的优点。多普勒引导与CT 引导比较, 具有简便、廉价的特点, 适合基层医院及贫困患者的应用,值得推广。

关键词: 关节炎, 骶髂关节, 多普勒, 治疗

Abstract: AIM: To investigate and comparatively observe the feasibility, security and effectiveness of Doppler guidance for therapeutic intra-articular sacroiliac joint injections with compound betamethasone in patients with sacroiliitis (grades Ⅱ-Ⅲ). METHODS: 71 cases with sacroiliitis were randomized into 3 groups:24 in Doppler group (DP), 23 in CT group and 24 in control group.DP and CT group were injected with compound betamethasone (7 mg/mL) into sacroiliac joints in a different guided way and followed up for 90 days.We recorded the related indexes of DASDAI, BASMI and BASFI on 1st, 7th, 30th, 60th and 90th days before and after treatment, and simultaneously measured the finger tips distance, Patrick test “4” and the scores of VAS to sacroiliac joints press. RESULTS: There was statistical difference when DP and CT group were compared with control group (P<0.05) in the indexes of DASDAI, BASMI, BASFI, experiment like number “4” and sacroiliac joints press after 1st, 7th and 30th days' treatment. There was also statistical difference in the comparison of finger tips distance after 1st, 7th and 30th days' treatment (P<0.05).But there was no statistical difference when DP was compared with CT during the 90 days' follow- up.In 47 patients with percutaneous puncture, 2 of DP and 1 of CT failed, the failure rates were 8.3 % and 4.6 %, respectively (P ≥0.05).1 of CT and 1 of control group discontinued observation because of abnormal re-laboratory data.1 of DP, 1 of CT and 2 of control group failed to be followed up. CONCLUSION: This initial experience suggests that with a comparison to CT guidance Doppler-guided therapeutic injection with compound betamethasone to sacroiliac joints is safe, rapid, easy and suitable to be widely used in the lower-level hospital and poverty patients.

Key words: arthritis, sacroiliac joint, Doppler, therapy

中图分类号:

R965.2

蒋峰, 梅艳, 费忆力, 邵立民, 姚晨, 邵永良, 史佳. 多普勒引导下骶髂关节腔注射可行性研究[J]. 中国临床药理学与治疗学, 2007, 12(1): 111-115.

JIANG Feng, MEI Yan, FEI Yi-li, SHAO Li-min, YAO Chen, SHAO Yong-liang, SHI Jia. Feasible study on sacroiliac joint internal injection performed under Doppler guidance[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2007, 12(1): 111-115.

参考文献

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