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疼痛醫學雜誌

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篇名 Successful pain control with paravertebral block for patients suffering from vertebral compression fracture
卷期 28:1
並列篇名 椎旁神經很阻斷可成坊控制壓迫性骨折的疼痛
作者 陳穎增徐偉哲蘇雲娟劉彥靑
頁次 001-006
關鍵字 Vertebral compression fractureparavertebral blockOsteoporosis脊椎壓迫性骨折脊椎旁神經阻斷骨質疏鬆TSCI
出刊日期 201803

中文摘要

背景: 脊椎壓迫性骨折(Vertebral compression fracture, VCF)是一個常見造成疼痛的疾 病,常見的原因是骨質疏鬆所引起。一旦產生脊椎壓迫性骨折,很可能造成病人的劇烈 疼痛而影響日常生活,甚至引起嚴重的併發症。目前對於脊椎壓迫性骨折的治療尚未有 明確的共識,本篇研究目的在了解脊椎旁神經阻斷(Paravertebral block,PVB)對於脊 椎壓迫性骨折造成疼痛的治療成效。 方法: 我們在2017年七月至2018年六月間,在疼痛門診收集因脊椎壓迫性骨折造成嚴重疼 痛(由脊椎X光攝影及沿著皮節分布的疼痛來確定診斷),接受超音波導引脊椎旁神經阻斷 止痛的病人。病人回診後會根據疼痛缓解狀況決定是否再次注射。 結果: 一共收集了十位病人(年齡:77.2±7.9,男:女=4:6),接受總數17次脊椎旁神經阻 斷(注射次數1.6±0.7,注射位置胸椎:腰椎=6:4)。從我們的追蹤發現脊椎旁神經阻斷可 以有效地缓解病人的疼痛(VAS=8.5±1.2減為3.6±1.6, P<0.01)。 結論: 我們的資料顯示脊椎壓迫性骨折的病人可以用脊椎旁神經阻斷來降低疼痛,但仍須 更造一步的對照研究來了解脊椎旁神經阻斷在治療脊椎壓迫性骨折疼痛中扮演的角色。

英文摘要

Background: Vertebral compression fracture (VCF) is a well-known,painflil condition that leads to lifestyle dysfunctions. Previous studies have shown that VCF is caused by osteoporosis and may cause severe pain. However, few researches have focused on the effect of nerve blocks on VCF. Methods: We collected VCF patients confirmed by X ray with severe pain and dermatome symptoms from July 2017 to June 2018 and performed a paravertebral block (PVB) under sono-guidance for pain control. Results: 10 patients (Age: 77.2±7.9, M/F: 4/6) were collected from our pain clinic, and a total of 17 PVBs (injection time: 1.610.7, spinal location: T/L: 6:4) were performed for all patients at 3-28 day intervals according to their pain location and severity. These patients were asked to come back for pain evaluation. Our data demonstrated that PVB may result in less pain sensation in VCF patients. (VAS=8.5土 1.2to3.6±1.6SJP<0.01). Conclusion: Our data clearly demonstrated that PVB provided better pain control for VCF patients with dermatome pain distribution. Further well controlled studies are needed to confirm the role of PVB in patients with pain caused by VCF.

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