股后皮神经及其主要分支神经痛的诊断与治疗  

Diagnosis and treatment of neuralgia of posterior femoral cutaneous nerve and its main branches

作　　者：苑继承[1] 史文锋[1] 程琰[1] 樊永卫[1] 许凤琴[1] 金绍岐[1] 

机构地区：[1]第四军医大学西京医院门诊部,陕西西安710032

出　　处：《局解手术学杂志》2012年第6期623-625,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨股后皮神经、臀下皮神经及阴唇(囊)后长神经各支神经痛的诊断与治疗。方法收集我院门诊软组织病痛患者中诊断为股后皮神经痛者159例,臀下皮神经痛者40例及阴唇后长神经痛者56例。诊断依据是按疼痛的部位及性质,查体所见的痛觉改变区域与各神经的分布区一致。治疗方法是用强的松龙混悬液1.2 mL(30 mg),加2%利多卡因5 mL及生理盐水5 mL,注射至臀大肌深处及下缘,1周后如不愈,再行第2次注射,少数2周后再行第3次注射。结果所有病例皆在注射后10min内止痛,检查神经分布区内痛觉丧失,数小时后大多数病例再现疼痛。1周后痊愈者共有190例,39例经第2次注射后痊愈,16例经第3次注射后痊愈,10例失访。结论对疑为股后皮神经或其分支臀下皮神经或阴唇(囊)后长神经痛者,经查体确定,排除臀部或腰部可能诱发疼痛的其他病变以后,采取强的松龙注射至臀大肌深处的方法,简便易行,疗效可靠,不失为首选的治疗方法。Objective To introduce the diagnosis and treatment of neuralgia of the posterior femoral cutaneous nerve, inferior cluneal nerve,and posterior long labial nerve. Methods 159 cases of posterior femoral cutaneous nerve,40 cases of inferior cluneal nerve and 56 cases of posterior long labial nerve, who were all diagnosed as neuralgia among patients with trouble and pain, were collected and analyzed. The diagnosis was made according to the scope of pain change ,which was identical to the territory of the nerve distribution. The method of treatment was local injection of 1.2 mL（30 mg） suspension of prednisolone,plus 5 mL of 2% lidocaine and 5 mL of normal saline,to the space beneath the gluteous maximus and to the deep fascia below the inferior margion of the muscle. One week later,if it did not recover, the second injection was given. In some cases third injection was given two weeks later. Results Pain was stopped within 10 minutes after in- jection in all cases. The skin pain sensation lost in the area of the nerve distribution. In most cases the pain reappeared a few hours later, but in mild degree. 190 cases recovered one week later. 30 cases recovered after second injection. 16 cases recovered after third injection, 10 cases were failed to be followed up. Conclusion To suspected case of neuralgia of the posterior femoral cutaneous nerve or its branches, the inferior cluneal nerve or the posterior long labial nerve, other pathological changes which could produce neuralgia of the nerve in the gluteal or lumbar region should be ruled out. Treatment with local injection of prednisolone deep into the gluteus maximus muscle which is easy and ef- fective is performed. It may be regarded as the first treatment option.

关 键 词：股后皮神经 神经痛 强的松龙 局部注射 

分 类 号：R745.4[医药卫生—神经病学与精神病学] R441.1[医药卫生—临床医学]