B超引导下神经阻滞治疗女性慢性盆腔痛  

Ultrasound-guided Nerve Block for Female Pelvic Pain

作　　者：贺豪杰[1] 郭红燕[1] 韩劲松[1] 朱馥丽[1] 李水清[2] 白志勇[3] 

机构地区：[1]北京大学第三医院妇产科,北京100083 [2]北京大学第三医院疼痛科,北京100083 [3]北京大学第三医院超声科,北京100083

出　　处：《中国微创外科杂志》2016年第12期1085-1088,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨B超引导下神经阻滞（nerve block,NB）治疗女性慢性盆腔痛（chronic pelvic pain,CPP）的疗效。方法 2012年11月-2015年12月,对20例慢性盆腔痛行神经阻滞治疗。均经详细询问病史及全面查体,制定神经阻滞方案,其中13例行阴部神经阻滞,6例行髂腹下/髂腹股沟神经阻滞,1例行腰骶脊神经背支阻滞。治疗前后采用视觉模拟评分（visual analog scale,VAS）评估疼痛情况,疼痛消失或VAS降低〉20%为有效。结果治疗前疼痛VAS（7.6±1.7）分,治疗结束时和治疗后3个月、6个月分别为（3.1±2.7）分、（4.3±2.9）分、（4.2±3.1）分,与治疗前相比,VAS均显著降低（t=8.421、6.716、6.133,P均=0.000）。治疗结束后6个月有效率75%（15/20）。结论 B超引导下神经阻滞是治疗女性慢性盆腔痛的有效方法,掌握好疼痛部位神经支配及适应证是治疗成功的关键。Objective To investigate the efficacy of ultrasound-guided nerve block for chronic pelvic pain（ CPP）.Methods Between November 2012 and December 2015,we collected 20 patients with CPP who had received ultrasound-guided nerve block therapy. Based on detailed history-taking and comprehensive examinations,we performed pudendal nerve block in 13 patients,iliohypogastric / ilioinguinal nerve block in 6 patients and spinal nerve block in 1 patient. The pain was assessed with visual analog scale（ VAS） before and after nerve block therapy. Results The VAS was decreased from（ 7. 6 ± 1. 7） before therapy to（ 3. 1 ± 2. 7） at24 hours post therapy（ t = 8. 421,P = 0. 000）,to（ 4. 3 ± 2. 9） at 3 months post therapy（ t = 6. 716,P = 0. 000）,and to（ 4. 2 ±3. 1） at 6 months post therapy（ t = 6. 133,P = 0. 000）. The efficacy rate（ disappearance of pain or VAS decreased by more than20%） was 75%（ 9 /12） at 6 months post therapy. Conclusions Ultrasound-guided nerve block is effective for female chronic pelvic pain. Mastery of the innervation area of the pain and the indication is the key to success.

关 键 词：神经阻滞 慢性盆腔痛 阴部神经阻滞 髂腹下/髂腹股沟神经阻滞 脊神经阻滞 

分 类 号：R711[医药卫生—妇产科学]