超声引导下连续腰交感神经节阻滞治疗下肢Buerger′s病的顽固性疼痛  

Ultrasonic guidance of continuous lumbar sympathetic block for the intractable pain of Burger's disease of lower limb

作　　者：徐晨婕[1] 史宏伟[1] 李陆军[2] 陆伟萍[1] 鲍红光[1] 

机构地区：[1]南京医科大学附属南京医院麻醉科,南京市210006 [2]南京市中西医结合医院

出　　处：《临床麻醉学杂志》2013年第11期1061-1063,共3页Journal of Clinical Anesthesiology

基　　金：南京医科大学科技发展基金项目(2010NJMU054)

摘　　要：目的观察超声引导下腰交感神经节阻滞治疗下肢Burger′s病的顽固性疼痛的疗效。方法 40例Buerger′s病患者随机均分为两组。超声引导下治疗组(A组):采用便携式彩色二维超声仪引导下行患侧连续腰交感神经节阻滞,置管两周;对照组(B组)给予抗抑郁药、抗惊厥药物治疗,观察期为两周。监测记录两组患者治疗前和治疗2周后的疼痛VAS评分、患肢皮温和有无血管神经及脏器损伤、恶心呕吐、感觉异常、运动减退、视物模糊、共济失调等不良反应的发生率。结果与B组比较,A组治疗2周后疼痛明显缓解,VAS评分显著下降,皮肤温度明显升高(P<0.01),且无其他严重并发症发生。结论超声直视引导下连续腰交感神经节阻滞技术,可提高穿刺成功率,减少并发症,可在下肢Buerger′s病所致神经病理性疼痛治疗中发挥短期效应。Objective To observe the therapeutic effect of ultrasonic-guided continuous lumbar sympathetic blocking on the intractable pain of Buerger＇s disease of lower limb. Methods Forty patients with painful Buergerrs disease of lower limb were equally randomized into group A and group B. Patients in group A were treated with ultrasonic-guided continuous lumbar sympathetic blocking the second lumbar sympathetic ganglion for 2 weeks, while patients in group B were treated with antidepressant and anticonvulsant drugs. VAS score, the skin temperature on the lower limb, and complications were evaluated before treatment and 2 weeks after treatment. Results The ultrasonic-guided continuous lumbar sympathetic blocking significantly relieved the refractory pain of the patients in group A, increased the skin temperature and decreased VAS score （P〈0. 01）. No other complications occurred except for temporary genitofemoral neuralgia. Conclusion It is effective for ultrasonic-guided continuous lumbar sympathetic block in the patients with neuropathic pain caused by Buerger＇s disease of lower limb.

关 键 词：超声引导 连续腰交感神经阻滞 Buerger’s病 

分 类 号：R614[医药卫生—麻醉学]