摘要
回顾性分析本院疼痛门诊2010年1月至2017年3月期间，采用神经阻滞方法治疗33例药物治疗无效的开颅术后重度颅外神经痛患者，男21例，女12例，年龄20～59岁，急性开颅术后头痛（3个月内）27例，持久性开颅术后头痛（3个月以上）6例。神经阻滞药物为曲安萘德10mg＋0．4％利多卡因溶液，每个穿刺点注射1～3ml。与治疗前比较，首次治疗后疼痛评分降低。27例急性开颅术后头痛患者中96％（26例）仅接受1次神经阻滞，4％（1例）接受2次神经阻滞后疼痛完全缓解；6例持久性开颅术后头痛患者中50％（3例）接受2次神经阻滞、33％（2例）接受3次神经阻滞、17％（1例）接受4次神经阻滞后疼痛完全缓解。平均疼痛完全缓解时间5（1～30）d。随访1个月无一例复发。均未见穿刺点感染、注射痛以及类固醇激素应用后相关的高血压等不良反应发生。综上所述，神经阻滞可安全有效地用于开颅术后重度颅外神经痛的治疗。
Thirty-three patients with severe extraeranial neuralgia after craniotomy （21 male, 12 female） , aged 20-59 yr, in whom drug treatment was ineffective, 27 patients with headache following a- cute craniotomy （within 3 months） and 6 patients with headache after long-time craniotomy （more than 3 months） underwent neural blockade from January 2010 to March 2017 in Pain Clinic at our hospital. Their treatment and outcomes were analyzed retrospectively. The solution for neural blockade contained triamcin- olonc acetonide 10 ml and 0.4% lidoeaine solution and was injected into each puncture site （ 1 - 3 ml）. Pain scores were decreased after the initial neural blockade when compared with that before therapy. Among the 27 patients with headache after acute craniotomy, there were 26 patients （96%） in whom complete pain relief was achieved only after one block and 1 patient （4%） after 2 times of block. Among the 6 pa- tients with headache after long-time eraniotomy, there were 3 patients （50%） in whom complete pain re- lief was achieved after 2 times of block, 2 patients （33%） after 3 times and 1 patient （17%） after 4 times. The average time of achieving complete pain relief was 5 （ 1 - 30） days. No recurrence was found during one-month follow-up period. No infection at the puneture site, injection pain or related adverse reac- tions after application of steroid hormones was observed. Neural blockade can be safely and effectively used to treat severe extraeranial neuralgia after eraniotomy.
出处
《中华麻醉学杂志》
CSCD
北大核心
2017年第11期1326-1328,共3页
Chinese Journal of Anesthesiology
基金
北京市卫生系统高层次人才（学科骨干）项目（2014-3-035）
