超声引导下颈神经后支联合颈肩肌脉冲射频治疗颈神经后支源性颈肩痛的疗效分析  

Analysis on the therapeutic effect of ultrasound-guided pulsed radiofrequency of cervical dorsal rami nerve combined with cervical shoulder muscle on neck and shoulder pain deriving from cervical dorsal rami nerve

作　　者：杨帆[1] 石华武 高嵩[1] 周密 张炎 於辉 向景 李建军[1] 周卫民[1] YANG Fan;Shi Huawu;GAO Song;ZHOU Mi;ZHANG Yan;YU Hui;XIANG Jing;LI Jianjun;ZHOU Weimin(Department of Pain Management,Wuhan Hankou Hospital,Wuhan 430012,China;Department of Pain Management,CR and WISCO General Hospital,Wuhan 430080,China)

机构地区：[1]武汉市汉口医院疼痛科,武汉430012 [2]华润武钢总医院疼痛科,武汉430080

出　　处：《中国临床新医学》2025年第1期66-70,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：武汉市卫生健康委科研项目(编号:WX19Z42)。

摘　　要：目的分析超声引导下颈神经后支联合颈肩肌脉冲射频治疗颈神经后支源性颈肩痛的疗效。方法招募2019年1月至2021年10月武汉市汉口医院疼痛科确诊为颈神经后支源性颈肩痛的患者72例。采用随机数字表法将其分为观察组(超声引导下行颈神经后支联合颈肩肌脉冲射频治疗)和对照组(超声引导下行颈神经后支脉冲射频治疗),每组36例。于治疗前和治疗后1 d、1周、1个月、3个月、6个月评估视觉模拟量表(VAS)评分、颈椎功能障碍指数(NDI),于治疗后6个月评估疗效和并发症发生情况。患者出院后采取门诊复诊或电话的方式进行随访。结果两组治疗后不同时间点VAS评分、NDI低于治疗前,治疗后3个月和治疗后6个月观察组VAS评分、NDI低于对照组,差异有统计学意义(P<0.05)。治疗前、治疗后1 d、治疗后1周和治疗后1个月两组VAS评分、NDI比较差异无统计学意义(P>0.05)。治疗后6个月观察组显著有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗后穿刺部位均无出血、感染、神经损伤等并发症发生。所有患者随访6个月以上,最长随访时间为1年。末次随访时对轻度缓解和无效患者均行颈神经后支联合颈肩肌脉冲射频,单次治疗后VAS评分均较治疗前下降>50%。结论超声引导下颈神经后支联合颈肩肌脉冲射频治疗颈神经后支源性颈肩痛患者的疼痛和颈椎功能改善明显,且安全有效。Objective To analyze the therapeutic effect of ultrasound-guided pulsed radiofrequency of cervical dorsal rami nerve combined with cervical shoulder muscle on neck and shoulder pain deriving from cervical dorsal rami nerve.Methods A total of 72 patients who were diagnosed with neck and shoulder pain deriving from cervical dorsal rami nerve in Department of Pain Management,Wuhan Hankou Hospital from January 2019 to October 2021 were recruited.The patients were divided into observation group(receiving therapy of ultrasound-guided pulsed radiofrequency of cervical dorsal rami nerve combined with cervical shoulder muscle)and control group(receiving therapy of ultrasound-guided pulsed radiofrequency of cervical dorsal rami nerve)by using random number table method,with 36 cases in each group.The Visual Analogue Scale(VAS)scores and Neck Disability Index(NDI)of the patients were assessed before treatment,and 1 day,1 week,1 month,3 months,and 6 months after treatment.The therapeutic effect and incidence of complications were assessed 6 months after treatment.The patients were followed up through their further consultations with their doctors in the outpatient department or phone calls after discharge.Results At different time points after treatment,the VAS scores and NDI in the two groups were lower than those before treatment.At 3 and 6 months after treatment,the VAS scores and NDI in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in VAS scores and NDI between the two groups before treatment,1 day after treatment,1 week after treatment,and 1 month after treatment(P>0.05).At 6 months after treatment,the significantly effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,there were no complications such as bleeding,infection and nerve damage at the puncture sites in both groups.All the patients

关 键 词：脉冲射频 颈神经后支 颈肩痛 颈肩肌 

分 类 号：R681.5[医药卫生—骨科学]