应用肩胛背神经阻滞联合肩胛下滑囊痛点注射治疗肩胛肋骨综合征的疗效观察  

Study on the clinical efficacy of dorsal scapular nerve block combined with trigger point injection in infra-scapular capsule for treatment of scapula and rib syndrome

作　　者：佟明建 李彦平[2] 

机构地区：[1]北京市房山区妇幼保健院麻醉科,北京102488 [2]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《临床和实验医学杂志》2017年第10期1032-1034,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察肩胛背神经阻滞联合肩胛下滑囊痛点注射方法治疗肩胛肋骨综合征临床效果。方法选择肩胛肋骨综合征患者31例,随机分为两组:单纯肩胛下滑囊注射组(A组,n=15),肩胛背神经阻滞联合肩胛下滑囊痛点注射组(B组,n=16)。治疗方法:(1)肩胛背神经阻滞;(2)肩胛下滑囊痛点阻滞(肩胛骨下滑囊或/和前锯肌下滑囊);治疗时间:1次/周,共4次。观察指标:(1)治疗前、后(2周和4周)局部静止时VAS疼痛评分;(2)治疗前、后(2周和4周)肩关节外展活动时VAS疼痛评分;(3)治疗前、后(2周和4周)肩胛周围放射痛。结果 (1)组内比较:A组治疗后4周与治疗前比较,三项VAS评分均明显降低,差异有统计学意义(P<0.05);B组治疗后2周、4周与治疗前比较,三项VAS评分均明显降低,差异有统计学意义(P<0.05)。(2)组间比较:B组治疗后2周和4周三项VAS疼痛评分均明显低于A组,差异有统计学意义(P<0.05)。结论应用肩胛背神经阻滞联合肩胛下滑囊痛点阻滞方法可以有效控制肩胛肋骨综合征的临床症状,临床疗效确定。Objective To observe the clinical therapeutic effect of dorsal scapular nerve block combined with trigger point injection in infra-scapular capsule in treatment of scapula and rib syndrome. Methods Thirty-one patients with scapula and rib syndrome including 16 males and 15 females with age range of 37 to 65 years old,were randomly assigned into group A（ n = 15） and group B,patients in group A were administrated with trigger point injection in infra-scapular capsule and patients in group B（ n = 16） were given with dorsal scapular nerve block combined with trigger point injection in infra-scapular capsule including capsule under scapular and/or capsule under anterior serratus muscle. The therapeutic injection was once a week and four times for a course. Items in two groups were observed as follows： firstly,visual analogue scale（ VAS） while shoulder in motionless state（ VAS-M） before the treatment,two weeks and four weeks after treatment; secondly,VAS scores in shoulder abduction motion（ VAS-A） before treatment,two weeks after treatment,and four weeks after treatment; thirdly,the radiating pain around the scapula（ RP） before treatment,two weeks after treatment,and four weeks afte treatment. Results Firstly,VAS scores in group A at the time of four weeks after treatment were significantly lower than those at the time before treatment（ P〈0. 05）,while the VAS scores in group B at the time of two weeks and four weeks after the treatment were significantly lower than those at the time before treatment（ P〈0. 05）. Secondly,the VAS scores at the time of two weeks and four weeks after treatment in group B were significantly lower than those of group A（ P〈0. 05）.Conclusion Dorsal scapular nerve block combined with trigger point injection in infra-scapular capsule can effectively control the clinical symptoms of scapula and rib syndrome with definitely therapeutic effect.

关 键 词：肩胛肋骨综合征 肩胛背神经阻滞 肩胛下滑囊 痛点注射 

分 类 号：R686[医药卫生—骨科学]