29例颈源性肘痛的诊断与治疗  

DIAGNOSIS AND TREATMENT OF CERVICAL-DERIVED ELBOW PAIN IN 29 PATIENTS

作　　者：薛锋[1] 陈德松[1] 顾玉东[1] Wiman 

机构地区：[1]复旦大学附属华山医院手外科,上海200040 [2]印度尼西亚万隆lmmanuel医院矫形外科

出　　处：《中国疼痛医学杂志》2002年第2期80-82,共3页Chinese Journal of Pain Medicine

基　　金：上海市医学领先专业重点学科基金资助(编号993015)

摘　　要：目的:探讨肘外侧疼痛与椎孔外颈神经根（5～7）卡压的关系。方法:对29例肘外侧疼痛同时伴有同侧颈部疼痛或压痛的患者进行治疗及分析:（1）24例接受了同侧颈部固定压痛点局封,封闭点一般位于胸锁乳突肌后缘中点,深达颈椎横突。（2）5例上干型胸廓出口综合征（ThoracicOutlet Syndrom,TOS）同时伴有同侧肘外侧疼痛的病人,进行臂丛神经松解加前、中、小斜角肌切断,并观察肘外侧疼痛缓解的效果。以上病例随访6～24个月。结果:24例患者经颈部压痛点阻滞后,13例疼痛及压痛完全消失,6例压痛明显减轻,2例略有缓解,3例无缓解。5例TOS患者,术后4例完全缓解,1例仍有轻度疼痛及压痛。结论:部分肘外侧疼痛可能是因椎孔外颈神经根（5～7）卡压所致。Objective: To investigate the relationship between resistant lateral elbow pain and cervical nerve roots (5~7) compression. Methods:Twenty-nine cases of patients who complained cervico-brachi-al neuralgia or neck-should-pain were treated and analysed: 1. Twenty-four patients received local block at the pain side of the neck. 2. Five lateral elbow pain patients who were diagnosed Thoracic Outlet Syn-drom(TOS) (Tipe of upper trunk) received brachial plexus neurolysis and scolinus recection. All patients were follow-up for 6 ~ 24 monthes. Results: Lateral elbow pain and tenderness of the 29 patients dissap-peard or relieved. Completely disappeared in 13 eases. Relieved obviously in 6 cases. Slightly relieved in 2 cases. Pain remained in 3 cases. Of all the 5 patients with TOS, pain and tenderness disappeared in 4. Conclusions: Some resistant lateral elbow pain maybe caused by neck nerve roots (5 ~7) compression.

关 键 词：颈源性肘痛 诊断 治疗 臂丛 颈臂神经痛 网球肘 神经压迫综合征 胸廓出口综合征 

分 类 号：R686.1[医药卫生—骨科学]