肩胛上神经阻滞并用三复合神经阻滞法治疗肩关节周围炎的作用  

Effect of suprascapular nerve block combined with triole nerve block for scapulohumeral periarthritis

作　　者：马松鹤[1] 孙玉[1] 严相默[1] 

机构地区：[1]延边大学医学院附属医院麻醉与疼痛研究室,吉林省延吉市133000

出　　处：《中国临床康复》2004年第23期4698-4699,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的研究和探讨肩胛上神经阻滞为主合用肩峰下关节阻滞、肩肱关节及触痛点阻滞、肱二头肌三角肌长肌腱肌束内浸润阻滞三复合神经阻滞法治疗肩关节周围炎(简称肩周炎)的疗效。方法①肩胛上神经阻滞按常规进行穿刺操作,注入10g/L利多卡因10mL。②三复合一是肩峰下关节阻滞,即肩峰下滑囊内穿刺注入“利泼合液”(5g/L利多卡因4mL+泼尼松62.5mg即2mL,共6mL)2mL;二是肩肱关节阻滞,即肱骨头与锁骨肩峰端交接处内下方3cm处刺针,注入同液2mL及肩胛骨内外侧缘触痛点局部阻滞;三是向肱二头肌、肱三角肌长肌腱肌束内用5g/L利多卡因行浸润阻滞。隔天1次,6次为1个疗程。结果治愈164例,占86.8%;好转17例,占9.0%;无效8例,占4.2%。结论肩胛上神经阻滞合用三复合神经阻滞是治疗肩周炎良好的基本方法。当遇到伴有放散痛或麻木时可并用星状神经节、颈部硬膜外阻滞以提高疗效。AIM:To study the effect of suprascapular nerve block combined with below of acromion block, bicipital groove in wich glides the bicipital tendon block, site of the subdeltoid block, trigger points block, three kind of block for scapulohumeral periarthritis.METHODS:①Suprascapular nerve block: It was performed according to the routine puncture procedure, and 10 mL lidocain (10 g/L) was injected. ②Triole nerve block: The first was the joint block of acromion that 2 mL L P mixed solution 2 mL lidoeaine(5 g/L)+62.5 mg Prednisolone(2 mL), totally 6 mL was injected into the subdeltoid bursa by puncture. The second was the joint block of shoulder and forearm,that 2 mL solution was injected into the site 3 mm inferior to the crossing between head of humerus and Acromial end of clavicle by puncture,and medial and lateral scapula trigger point regional block was performed.The third was 5 g/L lidocaine was injected into inter muscle of biceps brachii and deltoid brachii around the tendon for infiltration and blocking.The treatment was performed every other day,and 6 times as a course. RESULTS:Totally 164 cases were cured,occupying 86.8%,17 cases were improved,occupying 9.0%,8 cases were invalid,occupying for 4.2%.CONCLUSION: Suprascapular nerve block combined with triole nerve block is the main method to treat scapulohumeral periarthritis. Stellate ganglion block, cervical epidural block can also be used to improve the therapeutic effects when accompanied with spread pain, numbness.

关 键 词：肩凝症 神经传导阻滞 康复 

分 类 号：R681.7[医药卫生—骨科学]