CT引导下左右两侧腰交感神经射频热凝术后成功率的比较*

Comparison of success rate after CT guided radiofrequency thermocoagulation of left and right lumbar sympathetic nerves *

摘要:

目的：旨在观察CT引导下左右两侧腰交感神经射频热凝术后成功率间是否存在统计学差异，并基于解剖和技术层面探讨结局事件的影响因素。方法：选择嘉兴市第一医院疼痛科行CT引导下腰交感神经射频热凝术的患者共76例，所有患者均行双侧腰交感射频热凝，分成左、右两组，每组各76例次。观察左右两侧手术时间、CT扫描次数、补救措施实施率，手术前后双足的脉搏氧饱和度（SPO2）、足温（T）和灌注指数（PI）。结果：左侧的手术时间、CT扫描次数和无水酒精补救实施率明显低于右侧，差异具有统计学意义；两组术前SPO2、T和PI比较差异无统计学意义，但左侧术后的PI和T明显高于右侧，差异有统计学意义。结论：在CT引导下腰交感神经射频热凝术中，右侧操作难度大，成功率低，解剖因素可能是造成这种差异的重要原因。

Abstract:

Objective: The purpose of this study was to observe whether there is a statistical difference in the success rate of CT guided radiofrequency thermocoagulation of left and right lumbar sympathetic nerves, and to explore the influencing factors of outcome events based on anatomy and technical aspects. Methods: A total of 76 patients who underwent CT-guided radiofrequency thermocoagulation of lumbar sympathetic nerve in the pain Department of Jiaxing first Hospital were selected. All patients underwent bilateral lumbar sympathetic radiofrequency thermocoagulation and were divided into two groups: left group (n = 76) and right group (n = 76). The operation time, CT scanning times, implementation rate of remedial measures, pulse oxygen saturation (SPO2), foot temperature (T) and perfusion index (PI) of both feet before and after operation were observed. Results: The operation time, CT scanning times and anhydrous alcohol rescue rate on the left side were significantly lower than those on the right side, and the difference was statistically significant. There was no significant difference in preoperative SPO2, T and PI between two groups, but the postoperative PI and T on the left side were significantly higher than those on the right side, and the difference was statistically significant. Conclusion: In CT-guided radiofrequency thermocoagulation of lumbar sympathetic nerve, the right side is difficult to operate and the success rate is low. Anatomical factors may be an important reason for this difference.