目的:评估C型臂X光机引导下腰椎小关节内注射倍他米松对腰椎小关节病变所致慢性腰痛的疗效.方法:腰痛时间长于3个月,腰痛症状和体征符合腰椎小关节病变临床表现,经影像学和小关节内注射局麻药诊断性治疗后诊断为腰椎小关节病变的40例患者随机分为小关节注射组(n=20)和消炎镇痛药组(n=20).小关节注射组患者在C型臂X光机引导下行腰椎小关节内注射倍他米松,消炎镇痛药组患者口服双氯芬酸钠.腰痛程度采用视觉模拟评分法(visual analogue scale,VAS)评分.观察时间点定为治疗前(T0)和治疗后3个月(T1).主要观察患者的生命体征和VAS评分.根据治疗过程中VAS改善程度统计疗效(分为显效、有效和无效).结果:治疗后3个月注射组总有效率为92%,消炎镇痛药组总有效率为46%;注射组显效率为74%,消炎镇痛药组显效率为26%.注射组的总有效率和显效率均显著高于消炎镇痛药组(P<0.01).结论:C型臂X光机引导下腰椎小关节内注射倍他米松能有效缓解腰椎小关节病变所致慢性腰痛,疗效优于口服药物治疗.%Objective:To investigate the effects of injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine on patients with chronic low-back pain from the disfunction of lumbar facet joints. Methods: A total of 40 patients with low-back pain from the disfunction of lumbar facet joints more than 3 months were enrolled in this study. The patients were randomly divided into 2 groups(n = 20, each). The injection group received the injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine; while the medcine group received taking diclofenac sodium. The vital signs and visual analogue scale were recorded before the treatment(T0) and 3 months after the treatment(Ti ). The effects of treatment were evaluated according to the changes of visual analogue scale (VAS) and were divided into excellence, effectiveness, inefficiency. Results: There was a higher effective and excellence rate at T1 in the injection group than in the medcine group(P＜0. 01). The total effective rate at T1 in injection group was 92％ and in medcine group is 46％. The rate of excellence effect in injection group was 74 ％ and in medcine group was 26 ％. Conclusions.. There was a better effect by injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine on patients with chronic low-back pain from the disfunction of lumbar facet joints.
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