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[退行性脊柱疾病注射治疗的副作用和并发症]

[Side effects and complications of injection therapy for degenerative spinal disorders].

作者信息

Willburger R E, Knorth H, Haaker R

机构信息

Orthopädische Universitätsklinik Bochum.

出版信息

Z Orthop Ihre Grenzgeb. 2005 Mar-Apr;143(2):170-4. doi: 10.1055/s-2005-836452.

Abstract

AIM

The type and frequency of side effects due to treatment of vertebral pain syndromes with local injections were examined. Risks and complications were evaluated and precautions are presented in order to avoid these problems.

METHODS

The medical records of 453 patients who had undergone injection therapy in hospital for spinal pain syndromes were investigated retrospectively.

RESULTS

Paravertebral injections with cervical and lumbar spinal nerve analgesia, facet joint injections, lumbar epidural-perineural injections, epidural-dorsal and epidural-sacral injections, and injections next to the ileosacral joint were administered, amounting to a total of 7 963 injections. In 25 cases (0.3 %) unfavourable side effects were observed. Epidural-perineural injections led to headache in 10 cases and paravertebral lumbar nerve analgesia in 3 cases. Five times after epidural-perineural injections circulatory dysregulation with vertigo, nausea and decreased blood pressure was observed. One patient fell after an epidural-perineural injection, and one patient developed a sensory block up to the thoracic segment 6. Five patients showed local allergic reactions at the injection site after Mepivacain. All complications could be treated with simple symptomatic measures and had no severe effects.

CONCLUSION

Compared to other studies, only few side effects were observed. The injections described above may thus be regarded as low-risk therapy.

摘要

目的

研究局部注射治疗脊椎疼痛综合征的副作用类型及发生频率。评估风险和并发症,并提出预防措施以避免这些问题。

方法

回顾性调查453例因脊柱疼痛综合征在医院接受注射治疗患者的病历。

结果

进行了椎旁注射联合颈、腰脊神经镇痛、小关节注射、腰段硬膜外-神经周围注射、硬膜外-背侧及硬膜外-骶部注射,以及髂骶关节旁注射,共计7963次注射。观察到25例(0.3%)出现不良副作用。硬膜外-神经周围注射导致10例头痛,3例椎旁腰神经镇痛。硬膜外-神经周围注射后5次出现循环调节障碍,伴有眩晕、恶心和血压下降。1例患者在硬膜外-神经周围注射后跌倒,1例患者出现直至胸段6的感觉阻滞。5例患者在使用甲哌卡因后注射部位出现局部过敏反应。所有并发症均可通过简单的对症措施治疗,且无严重影响。

结论

与其他研究相比,观察到的副作用较少。因此,上述注射可视为低风险治疗。

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