超声引导下胭窝区坐骨神经注射松解术治疗膝后痛的疗效  

Efficacy of ultrasound-guided neurolysis of sciatic nerve in popliteal fossa for treatment of patients with popliteal fossa pain

作　　者：孟凡华[1] 季锋[2] 陈辉[2] 许华[2] 熊源长[2] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海市200040 [2]第二军医大学上海长海医院麻醉科,200433

出　　处：《实用疼痛学杂志》2016年第3期178-180,共3页Pain Clinic Journal

摘　　要：目的评价超声引导下胭窝区坐骨神经注射松解术治疗膝后痛患者的疗效。方法膝后痛患者25例，在膪窝区坐骨神经与胭动脉或腘静脉之间，实施超声引导下胭窝区坐骨神经注射松解术。注射用药采用0．25％利多卡因与复方倍他米松3．5mg共10ml，以及30μg／ml医用三氧10ml。记录患者术前及术后1、3个月时的NRS评分和膝关节改良HSS评分。结果4例患者、15例患者、6例患者分别经1、2、3次松解完成治疗。治疗前、治疗后1个月和3个月时的静态NRS分别为（2．2±1．4）、（1.3±1．1）和（1．4±1．1），动态NRS分别为（5．2±1．1）、（2．7±1．1）和（3．1±1．2）；膝关节改良HSS评分分别为（80±6）、（90±7）和（87±6）。与治疗前相比，治疗后1、3个月时的上述指标均明显改善（P〈0．05）。未见感染、神经或血管损伤等并发症。结论以胭窝区坐骨神经与胭动脉或腘静脉之间区域为靶点，超声引导下注射松解坐骨神经治疗膝后痛安全、有效。Objective To evaluate the efficacy of ultrasound-guided neurolysis of sciatic nerve in popliteal fossa for patients with popliteal fossa pain. Methods Twenty-five patients with popliteal fossa pain were collected. All patients were received the treatment of ultrasound-guided neurolysis in the region of sciatic nerve of popliteal fossa. The conjunction area of sciatic nerve, popliteal artery and popliteal vein was injected with 0.25% lidocaine and compound betamethasone 3.5mg, and 30μ g/ml medical ozone 10ml. NRS and modified HSS knee joint score were recorded preoperatively and one month, three months after the treatment. Results Four,fifteen and six patients were received the treatment one time, two times and three times respec- tively. NRS at rest was （2.2 ± 1.4）, （1.3 ± 1.1） and （1.4 ± 1.1） ,and NRS during movement was （5.2 ± 1.1）, （2.7 ± 1.1） and （3.1 ± 1.2） before the treatment and 1,3 months after the treatment respectively. Modified HSS knee score was （80 ± 6）, （90 ± 7） and （87 ± 6） respectively. Compared with pretreatment, all above indices were significantly improved after the treatment （P 〈 0.05）. No complications such as infection, neural or vascular injury were found. Conclusion Ultrasound-guided injection of lidocaine, betamethason and medical ozone between the area of sciatic nerve and popliteal artery or popliteal vein is a safe and effective method for the treatment of patients with popliteal fossa pain.

关 键 词：膝 疼痛 坐骨神经 神经松解术 超声检查 

分 类 号：R684[医药卫生—骨科学]