Wilkes Denise, Ganceres Natalie, Doulatram Gulshan, Solanki Daneshvari
Department of Anesthesiology and Pain Management, University of Texas Medical Branch, Galveston, Texas 77555, USA.
Pain Pract. 2009 Mar-Apr;9(2):145-9. doi: 10.1111/j.1533-2500.2008.00255.x. Epub 2008 Dec 10.
Successful pressure ulcer treatment is challenging and is often plagued with prolonged hospitalizations, multiple surgeries, and high recurrence rates. Pressure ulcer secondary to spinal cord injury is further complicated by spasticity, which contributes to both ulcer continuance and healing. This report illustrates the use of neurolytic regional techniques for spasticity control and pressure ulcer healing.
We present our experience with a paraplegic man who suffered from chronic right trochanteric and ischial pressure ulcers that failed to heal despite surgical and conservative treatment. We report the successful treatment of knee and hip flexor spasticity with a femoral and sciatic alcohol neuroablation technique. It was not until the successful control of his lower extremity spasticity that the pressure ulcers showed signs of healing. Neuroablation nay be considered for spasticity control when more conservative approaches fail or are not feasible.
成功治疗压疮具有挑战性，常常伴随着住院时间延长、多次手术以及高复发率。脊髓损伤继发的压疮因痉挛而更加复杂，痉挛既会导致溃疡持续存在，又会影响愈合。本报告阐述了使用神经溶解区域技术控制痉挛和促进压疮愈合的情况。
我们介绍了一名截瘫男性患者的治疗经历，该患者患有慢性右转子部和坐骨压疮，尽管接受了手术和保守治疗，但仍未愈合。我们报告了使用股神经和坐骨神经酒精神经消融技术成功治疗膝部和髋部屈肌痉挛的情况。直到其下肢痉挛得到成功控制，压疮才出现愈合迹象。当更保守的方法失败或不可行时，可考虑采用神经消融来控制痉挛。
