B超引导与传统手法阴部神经阻滞治疗女性阴部神经痛的比较

发布时间：2018-09-12 08:11

【摘要】：目的探讨B超引导阴部神经阻滞(pudendal nerve block,PNB)与传统阴部神经阻滞治疗女性阴部神经痛的疗效。方法回顾性分析2012年11月~2016年8月在我院就诊并接受阴部神经阻滞的40例阴部神经痛的资料,其中19例行B超引导下阴部神经阻滞(B超组),21例行传统阴部神经阻滞(传统组)。根据疼痛缓解情况进行1~3次神经阻滞。治疗前、第一次治疗后24 h和治疗结束3个月采用视觉模拟评分(visual analog scale,VAS)评估疼痛情况。结果 2组第一次治疗后24 h、治疗结束后3个月的疼痛VAS均显著低于治疗前(P=0.000),B超组治疗后24 h疼痛VAS较传统组更低(Z=-2.451,P=0.014),治疗后3个月2组无显著性差异(Z=-0.542,P=0.588)。主要不良反应及并发症:臀部及下肢麻木在B超组为31.6%(6/19),传统组为0(0/21),二者差异有统计学意义(Fisher检验,P=0.007);头晕在B超组为5.3%(1/19),传统组为38.1%(8/21),二者差异有统计学意义(χ~2=4.427,P=0.035)。结论 B超引导与传统手法阴部神经阻滞治疗女性阴部神经痛均有效,2组在治疗结束后3个月疼痛治疗效果无显著差异。
[Abstract]:Objective to investigate the effect of B-ultrasound guided pudendal nerve block (pudendal nerve block,PNB) and traditional pudendal nerve block on female pudendal neuralgia. Methods the data of 40 cases of pudendal neuralgia treated in our hospital from November 2012 to August 2016 were retrospectively analyzed. Among them, 19 cases were treated with B-ultrasound guided pudendal nerve block (B-ultrasound group) and 21 cases were treated with traditional pudendal nerve block (traditional group). According to the pain relief, 1 and 3 times of nerve block were performed. Before treatment, 24 hours after the first treatment and 3 months after treatment, the pain was assessed by visual analogue score (visual analog scale,VAS). Results the VAS of group B was significantly lower than that of group B at 24 h after the first treatment and 3 months after the end of treatment (P0. 000). The VAS of group B was lower than that of the traditional group at 24 h after the first treatment (ZP0. 451P0. 014), but there was no significant difference between the two groups at 3 months after treatment (Z-0. 542P0. 588). The main adverse reactions and complications were: hip and lower extremity numbness was 31.6% (6 / 19) in B ultrasonic group and 0 / 21 (0 / 21) in traditional group, the difference was statistically significant (Fisher test P0. 007), dizziness was 5. 3% (1 / 19) in B ultrasonic group and 38. 1% (8 / 21) in traditional group (蠂 2 4. 427 P 0. 035). Conclusion there is no significant difference between the two groups in the treatment of female pudendal neuralgia under the guidance of B-ultrasound and traditional manipulation of pudendal nerve block in 3 months after treatment.
【作者单位】：北京大学第三医院妇产科;北京大学第三医院疼痛科;北京大学第三医院超声科;
【分类号】：R711

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