超声引导肩胛背神经阻滞的可行性

发布时间：2018-01-22 19:04

本文关键词： 肩胛背神经神经阻滞超声检查第颈椎横突后结节　出处：《中国介入影像与治疗学》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下第5颈椎横突后结节(PTFCV)处阻滞肩胛背神经(DSN)的可行性。方法对20例单侧肩胛间区疼痛患者行超声检查,观察PTFCV及DSN,测量PTFCV距皮肤的垂直距离。并于PTFCV处行超声引导下DSN阻滞。记录操作时间、术中及术后并发症,并以疼痛缓解程度评估治疗效果。结果通过超声可准确识别所有患者的PTFCV,PTFCV距皮肤表面垂直距离为(1.09±0.22)cm。20例中,仅8例(8/20,40.00%)的DSN可被超声识别。对20例(20/20,100%)患者均成功实施超声引导下DSN阻滞,操作时间(9.05±0.41)min。术后患者疼痛缓解率为(70.92±17.15)%。未出现明显的术中及术后并发症。结论超声引导下于PTFCV处阻滞DSN省时、易行,且安全、有效。
[Abstract]:Objective to investigate the feasibility of using ultrasound to block DSNs of dorsal scapular nerve at PTFCVV of the 5th cervical vertebra. Methods 20 patients with unilateral interscapular pain were examined by ultrasound. PTFCV and DSNwere observed and the vertical distance between PTFCV and skin was measured. Under the guidance of PTFCV, DSN block was performed. The operation time, intraoperative and postoperative complications were recorded. The therapeutic effect was evaluated by the degree of pain relief. Results the PTFCV of all patients could be accurately identified by ultrasound. The vertical distance between PTFCV and skin surface was 1.09 卤0.22 cm 路20, only 8 cases were 8 / 20. DSN can be identified by ultrasound. Twenty patients (20 / 20 / 100) were successfully treated with ultrasound guided DSN block. The operating time was 9.05 卤0.41 min. The postoperative pain relief rate was 70.92 卤17.15). There were no obvious intraoperative and postoperative complications. Conclusion Ultrasound-guided block of DSN at PTFCV can save time. Easy, safe and effective.
【作者单位】：重庆医科大学超声影像学研究所;重庆医科大学附属第二医院超声科;重庆医科大学附属第二医院骨科;上海交通大学附属第六人民医院超声科;
【基金】：国家自然科学基金(81270021) 国家杰出青年科学基金(81425014) 教育部新世纪优秀人才支持计划[NCET-13-1067(212142)] 重庆市杰出青年基金(cstc2013jcyjjq10004)
【分类号】：R68;R445.1
【正文快照】： 肩胛间区疼痛临床常见,肩胛背神经(dorsal scapular nerve,DSN)病变是引起肩胛间区疼痛的主要原因[1]。DSN主要在椎前筋膜下由第5颈神经根分出并穿过中斜角肌向后向下走行,发出神经分支支配大小菱形肌[2-3]。有学者[4]尝试通过体表标志及神经刺激器定位DSN并对其进行阻滞,以治

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