不同股外侧皮神经阻滞对治疗股外侧皮神经卡压综合征的疗效对比观察  

Comparison of different lateral femoral cutaneous nerve block in treatment of lateral femoral cutaneous nerve entrapment syndrome

作　　者：李杰[1] 李彦平[2] 杨同文[1] LI Jie ;LI Yan-ping ;YANG Tong-wen .(Department of Anesthesiology, Traditional Chinese Medicine Hospital, Huairou District, Beijing 101400, China;Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]北京市怀柔区中医医院麻醉科,北京101400 [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》2018年第21期2345-2347,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察不同位置实施股外侧皮神经阻滞治疗股外侧皮神经卡压综合征的临床疗效。方法采用前瞻性随机对照研究,选择2016年4月至2018年3月首都医科大学附属北京友谊医院麻醉科疼痛门诊和北京市怀柔区中医医院麻醉科疼痛门诊收治的股外侧皮神经分布区疼痛、麻木患者28例。采用随机数字表法将患者均分为髂前上棘阻滞组(IB组,n=14)和腰丛神经阻滞组(LPB组,n=14)。两组患者在不同位置分别行股外侧皮神经阻滞(1次/周,共3周),同时嘱患者改变不良姿势和(或)解除异常压迫。设计4种评分方法综合评估治疗后股外侧皮神经的功能恢复状况,包括:异常感觉评分(PS)、视觉模拟评分(VAS)、症状分布的改变评分(SDS)、临床体征评分(PSS)。综合评分越高,表示功能恢复越好。结果两组患者治疗3周后,进行比较观察:(1)组内比较:两组治疗前、后综合评分结果显示:IB组(治疗前/治疗后:17. 46±2. 18/32. 15±3. 46)和LPB组(治疗前/治疗后:17. 36±2. 17/23. 79±2. 01)治疗后均比治疗前综合功能评分明显提高(P <0. 05)。(2)治疗后,IB组综合功能评分[(32. 15±3. 46)分]较LPB组[(23. 79±2. 01)分]高,差异具有统计学意义(P <0. 05)。结论股外侧皮神经卡压综合征实施IB治疗后综合功能评分明显高于LPN组,临床效果更佳。Objective To observe the clinical efficacy of lateral femoral cutaneous nerve block at different locations in treatment of lateral femoral cutaneous nerve entrapment syndrome. Methods In this prospective randomized controlled study, a total of 28 cases of pain and numbness in distribution area of the lateral femoral cutaneous nerve in the pain clinic of this hospital, and Traditional Chinese Medicine Hospital of Huairou District during April 2016 to March 2018 were randomly divided into anterior superior iliac spine block group （IB group, n=14） and lumbar plexus block group （LPB group, n =14） by using random number table method. Lateral femoral cutaneous nerve block （1 time/week, for 3 weeks） was performed at different locations in both groups, and patients were instructed to change bad posture and/or relieve abnormal compression. The following 4 scoring methods were designed to evaluate the functional recovery of lateral femoral cutaneous nerve after treatment, including： paresthesia scores （PS）, visual analogue scores （VAS）, symptom distribution scores （SDS）, clinical signs, physical sign scores （PSS）. The higher the overall scores, the better the functional recovery. Results Three weeks after the treatment, these two groups were compared and observed： ①After treatment, the scores of comprehensive function （IB group 32.15±3.46, LPB group 23.79±2.01） were significantly higher than those before treatment （IB group 17.46±2.18, LPB group 17.36±2.17） （ P 〈0.05）. ②After treatment, the IB group （32.15±3.46） had a higher overall functional scores than those of LPB group （23.79±2.01）, and there was a significant difference （ P 〈0.05）. Conclusion The comprehensive function scores of lateral femoral cutaneous nerve compression syndrome after IB treatment is significantly higher than that of LPN group, and the clinical effect is more effective.

关 键 词：股外侧皮神经卡压综合征 股外侧皮神经阻滞 髂前上棘阻滞 腰丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]