CT引导下蝶腭神经节联合选择性颈神经阻滞治疗蝶腭神经痛临床观察  

Clinical observation of CT-guided sphenopalatine ganglion combined with selective cervical nerve block in the treatment of sphenopalatine neuralgia

作　　者：李洪裕 唐树春 LI Hong-yu;TANG Shu-chun(Department of Pain,the People's Hospital of Ankang City,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市人民医院疼痛科,陕西安康725000

出　　处：《海南医学》2020年第21期2768-2771,共4页Hainan Medical Journal

摘　　要：目的探究CT引导下蝶腭神经节联合选择性颈神经阻滞治疗蝶腭神经痛(SPN)的临床效果。方法选择安康市人民医院于2016年7月至2019年3月收治的34例SPN患者作为研究对象,所有患者均在CT引导下采用蝶腭神经节联合选择性颈神经阻滞治疗。术前、术后1 d、术后7 d、术后1个月、术后3个月、术后6个月和术后12个月观察患者的视觉模拟评分法(VAS)评分及治疗效果,同时采用数字分级法评估患者术后不同时间的面部麻木发生情况。结果SPN患者在术后1 d、7 d、1个月、3个月、6个月和12个月的VAS评分分别为(3.11±0.67)分、(2.56±0.51)分、(2.08±0.45)分、(1.74±0.31)分、(1.52±0.26)分和(1.01±0.19)分,均明显低于术前的(7.13±1.23)分,VAS评分呈逐渐下降趋势,差异均有统计学意义(P<0.05);SPN患者在术后1 d、7 d、1个月、3个月、6个月和12个月的治疗总有效率分别为85.29%、94.12%、97.06%、100.00%、100.00%和100.00%,患者的治疗总有效率呈逐渐上升趋势,差异均有统计学意义(P<0.05);SPN患者在术后1 d、7 d、1个月、3个月、6个月和12个月的麻木总发生率分别为70.59%、50.00%、20.29%、11.76%、5.88%和2.94%,患者的麻木总发生率逐渐下降,差异均有统计学意义(P<0.05);所有患者在术后未见体位性高血压、颅内感染、视力障碍等严重不良反应发生,仅有3例患者在术后1 d出现面部轻血肿,经局部冰敷后完全消退。结论CT引导下蝶腭神经节联合选择性颈神经阻滞能够显著缓解SPN患者的头痛症状,具有起效快、持续时间长、治疗过程安全可靠等优势,值得临床上推广应用。Objective To research the clinical effect of CT-guided sphenopalatine ganglion combined with selective cervical nerve block in the treatment of sphenopalatine neuralgia.Methods Thirty-four patients with sphenopalatine neuralgia(SPN)who admitted to the People's Hospital of Ankang City from July 2016 to March 2019 were selected as the study objects.Under the guidance of CT,the patients with SPN were treated with sphenopalatine ganglion combined with selective cervical nerve block.The VAS score and therapeutic effect of SPN patients were observed before operation,1 day after operation,7 days after operation,1 month after operation,3 months after operation,6 months after operation,and 12 months after operation.At the same time,the digital grading method was used to evaluate the incidence of facial numbness in patients at different time after operation.Results The VAS scores of patients with SPN were(3.11±0.67)points,(2.56±0.51)points,(2.08±0.45)points,(1.74±0.31)points,(1.52±0.26)points,(1.01±0.19)points at 1 day after operation,7 days after operation,1 month after operation,3 months after operation,6 months after operation,and 12 months after operation,which were significantly lower than those of patients before operation(P<0.05);the VAS scores showed a decreasing trend.The total effective rates of patients with SPN were 85.29%,94.12%,97.06%,100.00%,100.00%,and 100.00%at 1 day after operation,7 days after operation,1 month after operation,3 months after operation,6 months after operation,and 12 months after operation,respectively,which showed a increasing tread(P<0.05).The total incidence of numbness in patients with SPN were 70.59%,50.00%,20.29%,11.76%,5.88%,and 2.94%at 1 day after operation,7 days after operation,1 month after operation,3 months after operation,6 months after operation,and 12 months after operation,which showed a decreasing trend(P<0.05).No serious adverse reactions such as postural hypertension,intracranial infection,and visual impairment were found in all patients with SPN.Only 3 patients

关 键 词：蝶腭神经痛 神经阻滞治疗 CT引导 蝶腭神经节 颈神经 疗效 

分 类 号：R745[医药卫生—神经病学与精神病学]