亚甲蓝阻滞坐骨神经治疗痛性神经病变的临床研究  

Clinical study of Methylene Blue Block Sciatic Nerve in the Treatment of Painful Neuropathy

作　　者：姜丽娟[1] 孔伟[1] 刘彦东[1] 蒋晓宇[1] 韩会民[1] JIANG Lijuan;KONG Wei;LIU Yandong;JIANG Xiaoyu;HAN Huimin(Daqing Fourth Hospital,Daqing,Heilongjiang 163712,China)

机构地区：[1]大庆市第四医院,黑龙江大庆163712

出　　处：《大医生》2020年第1期49-51,共3页Doctor

基　　金：黑龙江省卫生健康委课题,课题编号:2016-484。

摘　　要：目的探析亚甲蓝阻滞坐骨神经治疗痛性神经病变的临床应用效果。方法选取大庆市第四医院2017年3月至2019年1月收治的痛性神经病变患者20例,采用数表法分为2组,分别制定不同的治疗方案,其中罗哌卡因治疗组10例,亚甲蓝治疗组10例,并分析2组不同治疗方案的治疗效果。同时选取雄性Wistar大鼠60只,随机分为罗哌卡因治疗组30只,亚甲蓝治疗组30只,分别注射2%罗哌卡因0.05 mL、亚甲蓝0.2 mL/0.06 mL/0.02 mL,观察注射部位的病理变化,并对比治疗效果。结果通过视觉疼痛量表(VAS)进行疼痛评分显示,亚甲蓝治疗组疼痛评分明显低于罗哌卡因治疗组,同时亚甲蓝治疗组镇痛生效时间短于罗哌卡因治疗组,其数值差异明显,有统计学意义(P<0.05);2组不良反应发生率比较无显著差异(P>0.05)。另外在大鼠研究中发现,采用疼痛阈值测定工具,对罗哌卡因组和亚甲蓝组的大鼠分别注射后8 h、24 h,2组大鼠神经疼痛阈值存在显著差异,且亚甲蓝组大鼠的疼痛阈值明显高于罗哌卡因组的大鼠(P<0.05);分别治疗3 d、2周、4周,2组大鼠神经疼痛阈值比较差异无统计学意义(P>0.05)。结论亚甲蓝在痛性神经病变治疗中效果确切。Objective To explore the clinical effect of methylene blue block sciatic nerve in the treatment of painful neuropathy.Methods Totally 20 patients with painful neuropathy admitted to the fourth hospital of Daqing city from March 2017 to January 2019 were randomLy divided into two groups,including 10 patients in ropivacaine group and 10 patients in methylene blue group.At the same time,60 male Wistar rats were randomLy divided into two groups:Ropivacaine group(30 cases)and methylene blue group(30 cases).They were injected with 2%ropivacaine(0.05 mL)and methylene blue(0.2 mL/0.06 mL/0.02 mL)respectively to observe the pathological changes of the injection site and compare the therapeutic effect.Results According to the vas visual pain scale,the pain score of methylene blue treatment group was significantly lower than that of ropivacaine treatment group,and the effective time of analgesia in methylene blue treatment group was shorter than that of ropivacaine treatment group,with significant difference(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).In addition,in the study of rats,it was found that the pain threshold of rats in ropivacaine group and methylene blue group was significantly different 8 hours and 24 hours after injection,and the pain threshold of rats in methylene blue group was significantly lower than that of rats in ropivacaine group(P<0.05);3 d.At 2 and 4 weeks,there was no significant difference between the two groups(P>0.05).Conclusion Methylene blue is effective in the treatment of painful neuropathy.

关 键 词：亚甲蓝 坐骨神经 阻滞 疼痛 神经病变 

分 类 号：R47[医药卫生—护理学]