摘要
目的 探讨超声引导下连续腰交感神经节(LSG)阻滞对顽固性下肢疼痛患者疼痛介质及程度的影响。方法 选取顽固性下肢疼痛患者100例,依据随机数字表法分为药物组与阻滞组,每组50例。药物组给予加巴喷丁+甲钴胺治疗,阻滞组给予超声引导下连续LSG阻滞治疗,比较2组疼痛介质[降钙素基因相关肽(CGRP)、β-内啡肽(β-EP)、5-羟色胺(5-HT)]、疼痛程度[视觉模拟评分法(VAS)]、皮肤温度、不良反应。结果 2组治疗后CGRP、β-EP、5-HT低于治疗前,阻滞组治疗后CGRP、β-EP、5-HT低于药物组,差异有统计学意义(P<0.05)。2组治疗1、7d后VAS评分低于治疗前,阻滞组治疗1、7d后VAS评分低于药物组,差异有统计学意义(P<0.05)。2组治疗1、7d后皮肤温度高于治疗前,阻滞组治疗1、7d后皮肤温度高于药物组,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 超声引导下连续LSG阻滞可有效减少顽固性下肢疼痛患者疼痛介质释放,有利于改善患者疼痛程度及皮肤温度,且安全性好。
Objective To explore the effect of ultrasound-guided continuous lumbar sympathetic ganglion(LSG)block on the pain mediators and degree in patients with intractable pain of lower extremity.Methods Totally 100 patients with intractable pain of lower extremity were selected and randomly divided into drug group and block group,with 50 cases in each group.The drug group was treated with gabapentin and mecobalamin,and the block group was treated with ultrasound-guided continuous LSG block.The pain mediators[calcitonin gene-related peptide(CGRP),β-endorphin(β-EP),5-hydroxytryptamine(5-HT)],pain degree[visual analogue score(VAS)],skin temperature,and adverse reactions were compared between the two groups.Results The CGRP,β-EP and 5-HT levels after treatment in drug group and block group were significantly lower than those before treatment,the block group was significantly lower than those in drug group(P<0.05).At 1 and 7 days after treatment,the VAS scores in drug group and block group were significantly lower than those before treatment,and the VAS scores at 1 and 7 days after treatment in block group were significantly lower than those in drug group(P<0.05).At 1 and 7 days after treatment,skin temperature in drug group and block group were significantly higher than those before treatment,and skin temperature at the 1 and 7 days after treatment in block group were significantly higher than those in drug group(P<0.05).There was no significant difference in the incidence of adverse reactions between the drug group and block group(P>0.05).Conclusion Ultrasound-guided continuous LSG block can effectively reduce the release of pain mediators in patients with intractable pain of lower extremity,improve the pain degree and skin temperature,and has better safety.
作者
袁景和
宋卫军
艾芳
白宝艳
YUAN Jinghe;SONG Weijun;AI Fang;BAI Baoyan(Department of Pain,Affiliated Hospital of Yan'an University,Yan'an,Shaanxi,716000;B-Ultrasound Room,Affiliated Hospital of Yan'an University,Yan'an,Shaanxi,716000)
出处
《实用临床医药杂志》
CAS
2019年第13期23-26,共4页
Journal of Clinical Medicine in Practice
关键词
超声
腰交感神经节阻滞
顽固性下肢疼痛
疼痛介质
疼痛程度
ultrasound
continuous lumbar sympathetic ganglion block
intractable pain of lower extremity
pain mediators
pain degree
