超声引导下肩胛上神经脉冲射频与神经阻滞治疗慢性顽固性肩周痛的疗效分析  

Ultrasound-guided pulsed radiofrequency therapy of suprascapular nerve versus suprascapular nerve block for the treatment of chronic refractory shoulder pain: analysis of curative effect

作　　者：杨月华 符建 徐小青 史传岗 YANGYuehua;FU Jian;XU Xiaoqing;SHI Chuangang(Department of Ultrasound, Affiliated Haian Hospita, Nantong University, Nantong, Jiangsu Province 226600, Chin)

机构地区：[1]江苏南通大学附属海安医院超声科,226600 [2]江苏南通大学附属海安医院疼痛科,226600

出　　处：《介入放射学杂志》2018年第7期665-668,共4页Journal of Interventional Radiology

摘　　要：目的评估超声引导下肩胛上神经(SSN)脉冲射频(PRF)和神经阻滞治疗慢性顽固性肩周疼痛的疗效。方法收集80例慢性肩周疼痛患者临床资料,随机分为两组。A组使用超声引导下SSN阻滞(采用类固醇和局麻药的混合物),B组采用超声引导下SSN PRF治疗,每组40例。通过比较治疗前后疼痛视觉模拟量表(VAS),牛津大学肩关节评分(OSS)评估两种治疗方式的有效率。在治疗前和治疗后3、6个月,收集评价疗效参数。结果 A组平均VAS评分阻滞前为(6.41±1.22),3、6个月的随访分别为(2.07±1.10)和(2.69±1.23)。与治疗前比较差异有显著的统计学意义(P<0.001)。平均OSS评分患者阻滞前为(24.46±7.07),评分在3、6个月的随访分别为(37.48±4.92)和(39.82±5.41)。观察到显著OSS改善(P<0.001)。B组PRF前平均VAS评分为(6.42±1.43),3、6个月的随访评分分别为(0.95±0.14)和(1.25±1.08)。与治疗前比较差异有显著的统计学意义(P<0.001)。平均OSS评分患者PRF前为(23.60±7.69),3、6个月的随访评分分别为(40.83±7.01)和(42.27±6.30)。观察到显著OSS改善(P<0.001)。整个治疗期间未发生严重的治疗相关的并发症。结论超声引导下SSN的PRF神经调节以及SSN阻滞均是慢性顽固性肩痛的有效治疗方法,相对于SSN阻滞,SSN的PRF可以提供更有效的疗效。Objective To compare the curative effect of pulsed radiofrequency （PRF） of suprascapular nerve （SSN） with that of suprascapular nerve block in treating chronic refractory shoulder pain. Methods A total of 80 patients with chronic shoulder pain were enrolled in this study. The patients were randomly and equally divided into group A （n=40） and group B （n=40）. Patients in group A received suprascapular nerve block （using a mixture of local anaesthetic and steroid）, while patients in group B were treated with ultrasound-guided PRF of SSN. Visual analogue scale （VAS） score for pain and Oxford shoulder score （OSS） were determined before and after treatment, the results were used to assess the effective rates of two treatment methods. The therapeutic parameters for evaluation of curative effect were collected before the treatment as well as at 3 and 6 months after the treatment. Results The mean preoperative VAS score in group A was （6.41±1.22）, which became （2.07±1.10） and （2.69±1.23） at 3 and 6 months after the treatment respectively. The 3-month and 6-month postoperative VAS scores were significantly different from the preoperative VAS score （P〈0.001）. The mean preoperative OSS score in group A was （24.46±7.07）, which became （37.48±4.92） and （39.82 ±5.41 ） at 3 and 6 months after the treatment respectively. Obvious improvement of OSS was observed （P〈0.001）. In group B, the mean VAS score before PRF was （6.42±1.43）, which became （0.95±0.14） and （1.25±1.08） at 3 and 6 months after PRF respectively, the postoperative VAS scores were significantly different from the preoperative VAS score （P〈0.001）. The mean OSS score before PRF was （23.60±7.69）, which became （40.83±7.01） and （42.2±6.30） at 3 and 6 months after PRF respectively. After PRF the improvement of OSS was statistically significant （P〈0.001）. No procedure-related severe complieatinns oeeurred during the entire treatment period. Conclusion Both ultrasou

关 键 词：慢性肩周疼痛 肩胛上神经 脉冲射频 神经阻滞 

分 类 号：R681.7[医药卫生—骨科学]