超声引导下腋神经阻滞治疗四边孔综合征患者的可行性  

Feasibility of ultrasound-guided axillary nerve block for the treatment of patients with quadrilateral space syndrome

作　　者：牛杰杰 路桂军 王超 Niu Jiejie;Lu Guijun;Wang Chao(Department of Pain Management,Xiamen Chang Gung Hospital,Xiamen City,Fujian Province 361028,China;Department of Pain Management,Beijing Tsinghua Changgung Hospital,Beijing City 102218,China)

机构地区：[1]厦门长庚医院疼痛科,厦门市361028 [2]北京清华长庚医院疼痛科,北京102218

出　　处：《中华疼痛学杂志》2022年第4期509-514,共6页Chinese Journal Of Painology

摘　　要：目的评价超声引导下腋神经阻滞治疗四边孔综合征(QSS)患者的可行性。方法收集2020年12月至2021年8月在厦门长庚医院疼痛科及北京清华长庚医院疼痛科门诊就诊的QSS患者60例,年龄18~75岁,性别不限,单侧发病。采用随机数字表法,将其随机分为神经阻滞组和电疗组,每组30例。电疗组采用常规药物治疗及物理治疗,神经阻滞组在电疗组治疗基础上增加超声引导下腋神经阻滞治疗(0.5%利多卡因+1 mg/ml醋酸曲安奈德注射液1 ml,共20 ml),1次/周,疗程2周。治疗结束后2周,评价两组患者视觉模拟评分(VAS)、Constant-Murley肩关节功能评分(CMS)及不良反应情况。结果治疗结束后2周,神经阻滞组患者VAS评分明显低于电疗组[(2.3±1.8)分比(3.5±2.4)分,t=-2.14,P=0.037];神经阻滞组患者CMS(疼痛、日常生活活动水平、关节活动度及肌力)各子项及总分均明显高于电疗组(P均<0.05)。且两组均未见不良反应。结论超声引导下腋神经阻滞治疗可以优化常规物理疗法对QSS患者的治疗效果,且未增加不良反应。Objective To evaluate the feasibility of ultrasound-guided axillary nerve block for the treatment of patients with quadrilateral space syndrome(QSS).Methods Sixty patients with QSS from the Department of Pain Management,Xiamen Chang Gung Hospital and Beijing Tsinghua Changgung Hospital between December 2020 and August 2021,aged 18-75 years old,both sexes,involved unilateral onset,were divided into nerve blocking group and physical therapy group by the random number table,30 cases in each group.Patients were treated by ultrashort wave electrotherapy in the physical therapy group,while patients were treated by ultrasound guided axillary nerve block(0.5%lidocaine+1 mg/ml triamcinolone acetonide acetate 1 ml,20 ml in total)in the nerve blocking group,1 time/week,for 2 weeks on the basis of physical therapy.Visual analogue scale(VAS),Constant-Murley score(CMS)and adverse reactions were recorded in the two groups at 2 weeks after the treatment.Results VAS was signifcantly lower in the nerve blocking group than that in the physical therapy group at 2 weeks after the treatment[(2.3±1.8)vs.(3.5±2.4),t=-2.14,P=0.037].Each item(pain,daily living activity level,join range of motion and muscle strength)and total score of CMS were significantly higher in the nerve blocking group than those in the physical therapy group(all P<0.05).There were no adverse reactions occurred in both groups.Conclusion Ultrasound guided axillary nerve block can optimize the efficacy of conventional physical therapy for the treatment of patients with QSS,without increasing adverse reactions.

关 键 词：神经传导阻滞 腋神经 四边孔综合征 超声检查 多普勒 

分 类 号：R614[医药卫生—麻醉学]