超声引导行DSN阻滞对单侧肩胛间区疼痛患者疗效的有效性及安全性研究  

Efficacy and safety of ultrasound-guided dorsal scapular nerve block in patients with unilateral interscapular pain

作　　者：祖宝利 石胜驰 ZU Bao-li;SHI Sheng-chi(Department of Anesthesiology,Guizhou International General Hospital,Guizhou Province,Guiyang 550018,China)

机构地区：[1]贵黔国际总医院麻醉科,贵州贵阳550018

出　　处：《河北医科大学学报》2022年第8期945-949,共5页Journal of Hebei Medical University

基　　金：贵州省卫生健康委科学技术基金项目(gzwjkj2020-1-244)。

摘　　要：目的探讨超声引导下肩胛背神经(dorsal scapular nerve,DSN)阻滞治疗单侧肩胛间区疼痛的疗效以及安全性。方法选择我院收治的单侧肩胛间区疼痛患者156例,随机数字表法将患者分为两组,各78例。对照组采用颈肩部手法推拿治疗,观察组在对照组基础上联合超声引导下DSN阻滞治疗。比较2组患者疼痛程度、肩关节活动度、上肢功能、生活质量差异。结果2组治疗4周、12周视觉模拟(visual analog scale,VAS)评分均较治疗前降低(P<0.05),肩关节前屈被动关节活动度(passive range of motion,PROM)、后伸PROM、内旋PROM、外旋PROM、Fugl-Meyer运动功能量表上肢部分(Fugl-Meyer motor Function Scale upper limb,FMA-UE)评分、改良Barthel指数(modified Barthel index,MBI)评分均较治疗前增加(P<0.05)。观察组治疗4周、12周VAS评分低于对照组(P<0.05),肩关节前屈PROM、后伸PROM、内旋PROM、外旋PROM、FMA-UE评分、MBI评分高于对照组(P<0.05)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论超声引导下DSN阻滞可有效降低单侧肩胛间区疼痛患者疼痛程度,改善颈肩活动功能,提高生活质量。Objective To investigate the efficacy and safety of ultrasound-guided dorsal scapular nerve(DSN)block in the treatment of unilateral interscapular pain.Methods A total of 156 patients with unilateral interscapular pain admitted to our hospital were divided into two groups by random number table method,with 78 patients in each group.The control group was treated with neck and shoulder manipulation,and the observation group was treated with DSN block under ultrasound guidance on the basis of the control group.The pain degree,range of motion(ROM)of shoulder joint,upper limb function,and quality of life were compared between two groups.Results Visual analog scale(VAS)score in two groups decreased at 4 weeks and 12 weeks after treatment compared with that before treatment(P<0.05).Passive range of motion(PROM)of shoulder flexion,extension,internal rotation and external rotation,and Fugl-Meyer Assessment-Upper Extremity(FMA-UE)score,and modified barthel index(MBI)score increased compared with those before treatment(P<0.05).VAS scores in the observation group were lower than those in the control group at 4 weeks and 12 weeks after treatment(P<0.05),while PROM of shoulder flexion,extension,internal rotation and external rotation,FMA-UE score and MBI score were higher than those in the control group(P<0.05).There was no statistical difference in the incidence of complications between two groups(P>0.05).Conclusion Ultrasound-guided DSN block can effectively reduce the pain degree of patients with unilateral interscapular pain,improve the neck and shoulder activity function,and improve the quality of life.

关 键 词：肩胛背神经 疼痛 超声 

分 类 号：R614.4[医药卫生—麻醉学]