超声引导肩胛上神经阻滞的临床应用  

Clinical application of ultrasound-guided suprascapular nerve block

作　　者：李加平[1] 张飒[1] 朱婷 孙宇[1] 龙劲松[1] 郑虎山[2] 

机构地区：[1]广东医学院附属南山医院超声科,广东深圳518052 [2]广东医学院附属南山医院疼痛科,广东深圳518052

出　　处：《中国介入影像与治疗学》2013年第3期167-170,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：深圳市科技课题基金(201203200)

摘　　要：目的探讨超声引导肩胛上神经阻滞的临床应用价值。方法对接受肩胛上神经阻滞的75例肩周炎患者行超声检查,观察肩胛上神经、血管及肩胛上横韧带的位置及毗邻关系,选择最佳穿刺点,于实时超声引导下行肩胛上神经阻滞。术后随访12周,应用视觉模拟评分法(VAS)评定术前、术后患者疼痛程度。结果超声清晰显示71例肩胛上神经,4例不能确定,需利用神经刺激定位仪予以确认;75例均穿刺成功,成功率100%,未发生神经损伤及其他并发症。术前及术后1、4、12周的VAS评分分别为7.71±0.87、3.86±0.57、2.83±0.31及1.97±0.30,各时间点间差异均有统计学意义(P均<0.01)。结论超声引导下肩胛上神经阻滞具有实时、安全、无辐射等优点,有望在临床上推广应用。Objective To explore the clinical application value of ultrasound-guided suprascapular nerve block. Methods Seventy-five patients of scapulohumeral periarthritis with the need of suprascapular nerve block underwent ultrasound, and the location and adjacent relationship of suprascapular nerve, vascular and superior transverse scapular ligament were observed,in order to choose the optimal puncture point. Suprascapular nerve block was performed under real time ultrasound guidance. All the patients were followed up for 12 weeks and assessed by visual analogue scale （VAS） before and after operation. Results The suprascapular nerve was showed clearly in 71 patients, while in 4 patients was confirmed by nerve stimulation positioning. The success rate of ultrasoound-guided puncture was 100%, no nerve injury nor other complications occurred. The VAS score of preoperative and 1, 4 and 12 weeks after treatment was 7.71±0.87, 3.86±0.57, 2.83±0.31 and 1.97±0.30, respectively （all P〈0.01）. Conclusion Suprascapular nerve block under the guidance of ultrasound has the advantages of real-time guidance, safety, no radiation, and is expected to be popularized.

关 键 词：超声检查 关节炎 肩关节 肩胛上神经 神经阻滞 

分 类 号：R445.1[医药卫生—影像医学与核医学] R684.3[医药卫生—诊断学]