超声引导肩胛背神经阻滞的可行性  

Feasibility of dorsal scapular nerve block with ultrasound guidance

作　　者：杨晶[1,2] 晏铮剑[3] 周黎[2] 成涓[2] 向醒 郑元义[1,4] 张腾飞[3] YANG Jing YAN Zhengjian ZHOU Li CHENG Juan XIANG Xing ZHENG Yuanyi ZHANG Tengfei(Institute of Ultrasound Imaging, Chongqing Medical University, Chongqing 400010, China Departiment of Ultrasound Departiment of Orthopaedics, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China Departiment of Ultrasound, the Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China)

机构地区：[1]重庆医科大学超声影像学研究所,重庆400010 [2]重庆医科大学附属第二医院超声科,重庆400010 [3]重庆医科大学附属第二医院骨科,重庆400010 [4]上海交通大学附属第六人民医院超声科,上海200233

出　　处：《中国介入影像与治疗学》2017年第1期27-30,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金(81270021);国家杰出青年科学基金(81425014);教育部新世纪优秀人才支持计划[NCET-13-1067(212142)];重庆市杰出青年基金(cstc2013jcyjjq10004)

摘　　要：目的探讨超声引导下第5颈椎横突后结节(PTFCV)处阻滞肩胛背神经(DSN)的可行性。方法对20例单侧肩胛间区疼痛患者行超声检查,观察PTFCV及DSN,测量PTFCV距皮肤的垂直距离。并于PTFCV处行超声引导下DSN阻滞。记录操作时间、术中及术后并发症,并以疼痛缓解程度评估治疗效果。结果通过超声可准确识别所有患者的PTFCV,PTFCV距皮肤表面垂直距离为(1.09±0.22)cm。20例中,仅8例(8/20,40.00%)的DSN可被超声识别。对20例(20/20,100%)患者均成功实施超声引导下DSN阻滞,操作时间(9.05±0.41)min。术后患者疼痛缓解率为(70.92±17.15)%。未出现明显的术中及术后并发症。结论超声引导下于PTFCV处阻滞DSN省时、易行,且安全、有效。Objective To evaluate the feasibility of dorsal scapular nerve （DSN） block on the surface of posterior tubercle of the fifth cervical vertebra （PTFCV） under ultrasound guidance. Methods Ultrasonography was performed on 20 patients with interscapular pain to assess the PTFCV and DSN. The vertical distance between PTFCV and the skin was measured. DSN block on the surface of PTFCV was guided by ultrasound. The procedure duration, intraoperative and postoperative complications were recorded. The effect was evaluated by pain relief rate. Results The PTFCVs of all cases were clearly visible, and the vertical mean distance from the skin surface to PTFCV was （1.09±0.22）cm. The DSNs of 8 cases （8/20, 40.00%） could be seen with ultrasound guidance. DSN block was performed successfully in all 20 cases （20/20, 100%） under ultrasound guidance. The mean procedure duration was （9.05±0.41）min. The postoperative pain relief rate was （70.92±17.15）%. No obvious intraoperative and postoperative complication occurred. Conclusion Blocked DSN on the surface of PTFCV is proved feasible because of the advantages of timesaving, safety and effectivity.

关 键 词：肩胛背神经 神经阻滞 超声检查 第5颈椎横突后结节 

分 类 号：R68[医药卫生—骨科学] R445.1[医药卫生—外科学]