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超声引导与透视引导下颈深丛阻滞治疗颈源性头痛的比较

Ultrasound-Guided versus Fluoroscopy-Guided Deep Cervical Plexus Block for the Treatment of Cervicogenic Headache.

作者信息

Wan Qing, Yang Haiyun, Li Xiao, Lin Caina, Ke Songjian, Wu Shaoling, Ma Chao

机构信息

Pain Treatment Centre of Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.

Department of Medical Ultrasonics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.

出版信息

Biomed Res Int. 2017;2017:4654803. doi: 10.1155/2017/4654803. Epub 2017 Feb 23.

Abstract

. The aim of this study was to compare the efficacy of ultrasound-guided deep cervical plexus block with fluoroscopy-guided deep cervical plexus block for patients with cervicogenic headache (CeH). . A total of 56 patients with CeH were recruited and randomly assigned to either the ultrasound-guided (US) or the fluoroscopy-guided (FL) injection group. A mixture of 2-4 mL 1% lidocaine and 7 mg betamethasone was injected along C and/or C transverse process. The measurement of pain was evaluated by patients' ratings of a 10-point numerical pain scale (NPS) before and 2 wks, 12 wks, and 24 wks after treatments. . The blocking procedures were well tolerated. The pain intensity, as measured by NPS, significantly decreased at 2 wks after injection treatment in both US and FL groups, respectively, compared with that of baseline ( < 0.05). The blocking procedures had continued, and comparable pain relieving effects appeared at 12 wks and 24 wks after treatment in both US and FL groups. There were no significant differences observed in the NPS before and 2 wks, 12 wks, and 24 wks after treatment between US and FL groups. . The US-guided approach showed similar satisfactory effect as the FL-guided block. Ultrasonography can be an alternative method for its convenience and efficacy in deep cervical plexus block for CeH patients without radiation exposure.

摘要

本研究旨在比较超声引导下与透视引导下颈深丛阻滞治疗颈源性头痛(CeH)患者的疗效。共招募56例CeH患者,随机分为超声引导(US)注射组或透视引导(FL)注射组。将2 - 4 mL 1%利多卡因和7 mg倍他米松的混合液沿C2和/或C3横突注射。通过患者在治疗前以及治疗后2周、12周和24周对10分数字疼痛量表(NPS)的评分来评估疼痛程度。阻滞操作耐受性良好。与基线相比,US组和FL组在注射治疗后2周时,通过NPS测量的疼痛强度均显著降低(P < 0.05)。阻滞操作持续进行,US组和FL组在治疗后12周和24周时出现了相当的止痛效果。US组和FL组在治疗前以及治疗后2周、12周和24周的NPS评分之间未观察到显著差异。超声引导方法与透视引导阻滞显示出相似的满意效果。超声检查因其在CeH患者颈深丛阻滞中的便利性和有效性,且无辐射暴露,可作为一种替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66c7/5343221/1ca473f0d414/BMRI2017-4654803.001.jpg

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