腰交感神经毁损治疗下肢血运重建术后疼痛的临床观察  

作　　者：刘华波[1] 赵彩红 陶高见[2] 

机构地区：[1]浙江省舟山医院,316000 [2]江苏省南京鼓楼医院,210008

出　　处：《浙江临床医学》2020年第7期1020-1022,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省舟山市科技计划项目(2012C13020)。

摘　　要：目的观察CT引导下应用无水乙醇腰交感神经毁损对下肢血运重建术后疼痛患者的疗效.方法下肢血运重建术后仍剧烈疼痛的患者13例,应用无水乙醇进行相应腰交感神经毁损,随访30d,观察和评估患者治疗前后静息疼痛评分(VAS)、奥施康定用量、局部皮肤温度及皮温差.结果13例患者术后疼痛症状均有所缓解,术后口服奥施康定患者人数减少(P<0.05).术前VAS评分与皮温差呈正相关性(r=0.853,R^2=0.831,P<0.0001).术后患者VAS评分、药物使用剂量及皮温差明显减小,患肢皮温显著增加(P<0.05).结论腰交感神经毁损对下肢血运重建术后顽固性下肢疼痛有明显缓解效果.Objective To explore the efficacy of lumbar sympathetic nerve ablation guided by CT with dehydrated alcohol on pain treatment after revascularization in lower extremity for ischemia.Methods A total of 13 cases who underwent surgical intervention for ischemia with a severe pain were included in this study.Chemical lumber sympathectomy with alcohol were performed in these patients under CT guidance.Visual analogue scales(VAS)scores,skin temperature of lower limb and the oral drug dose of Oxycontin were compared before and after treatment within 30 days follow-up.Results All of the patients reported substantial pain relief and the number of patients taking Oxyconrin was decreased following operation(P<0.05).Baseline VAS scores were positively correlated with skin temperature difference before the treatment(r=0.853,R^2=0.831,P<0.0001).VAS scores,the oral dose of Oxycontin and skin temperature difference was remarkable reduced and the affected limb temperature was significantly raised(P<0.05).Conclusion Lumbar sympatehetic nerve chemical lesion with alcohol guided by CT can be effective to relieve the severe pain after revascularization in lower extremity for ischemia.

关 键 词：腰交感神经 无水乙醇 血运重建 下肢缺血 疼痛 

分 类 号：R54[医药卫生—心血管疾病]