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目的探讨经第3骶后孔穿刺硬膜外阻滞治疗原发性痛经的可行性与安全性。方法将原发性痛经患者78例随机分为2组,各39例,A组采用0.3%利多卡因25ml经第3骶后孔穿刺硬膜外阻滞,B组予布洛芬缓释胶囊(芬必得)口服治疗,于治疗前及治疗后12个月观察疼痛持续时间及视觉模拟评分(VAS)。结果治疗1个疗程结束当天及结束后1、4、8、12个月各时段与治疗前相比,A、B组VAS评分明显降低,疼痛持续时间明显缩短(P均<0.05);且A组的疼痛持续时间(除疗程结束当天外)均短于B组(P<0.05),VAS评分均低于B组(P均<0.05)。治疗结束后12个月,A组总有效率明显高于B组(94.87%vs61.54%,P<0.05)。结论经第3骶后孔硬膜外阻滞治疗原发性痛经是安全有效的方法。
Objective To explore the feasibility and safety of the treatment of primary dysmenorrhea after the third sacral hole puncture epidural block. Methods 78 cases of primary dysmenorrhea were randomly divided into two groups, 39 cases in each group. A group received 0.3% lidocaine 25ml through the third sacral hole puncture epidural block, B group ibuprofen sustained release capsules (Fenbid) orally, pain duration and visual analogue scale (VAS) were observed before treatment and 12 months after treatment. Results Compared with before treatment, the VAS scores of A and B groups were significantly decreased and the duration of pain was significantly shortened (P <0.05) at the end of 1 treatment and 1, 4, 8 and 12 months after treatment. The duration of pain (except on the day of end of treatment) was shorter in group B than in group B (P <0.05), and the VAS score was lower in group B than in group B (all P <0.05). At 12 months after the end of treatment, the total effective rate in group A was significantly higher than that in group B (94.87% vs 61.54%, P <0.05). Conclusion The treatment of primary dysmenorrhea by the third post-sacral hole epidural block is a safe and effective method.