摘要： 目的 比较超声引导下星状神经节阻滞术（US-SGB）与传统盲法穿刺星状神经节阻滞术（B-SGB）治疗乳腺癌术后神经病理性疼痛的效果。方法 48 例乳腺癌术后上肢疼痛患者被随机分为US-SGB 组（24 例）和B-SGB 组（24 例），均于患侧施行2 次星状神经节阻滞治疗，间隔时间为8 天；治疗后第4 和8 周时通过视觉模拟评分（VAS）评价疼痛改善程。结果 两组患者经阻滞治疗后，VAS 评分均显著下降、疼痛程度缓解，第4 周时VAS 评分分别为（2.68 ± 1.33）分（US-SGB 组）和（3.31 ± 1.27）分（B-SGB组），第8 周时为（1.32 ± 0.85）和（2.09 ± 1.02）分，US-SGB 组患者疼痛缓解程度优于B-SGB 组（4 周：t = 2.251，P = 0.038；8 周：t = 1.971，P = 0.029）。结论 于超声引导下和传统盲法穿刺星状神经节阻滞术对乳腺癌术后疼痛均有效；但超声引导下星状神经节阻滞术临床疗效显著，优于传统盲法穿刺星状神经节阻滞术，值得在临床推广应用。
关键词:
神经传导阻滞,
星状神经节,
乳房切除术, 改良根治性,
神经痛,
超声检查, 多普勒, 彩色
Abstract: Objective To compare the efficacy of ultrasound-stellate ganglion block (US-SGB) with that of blind SGB (B-SGB) in the management of breast cancer patients with postoperative neuropathic pain (NP). Methods Forty-eight breast cancer patients with postoperative neuropathic pain were randomly assigned to either US-SGB group (N = 24) or B-SGB group (N = 24). The mean age of US-SGB and B-SGB groups were (51.35 ± 5.63) and (49.54 ± 4.77) years, respectively. Two blockade procedures with 8-day interval were performed on the affected side. Visual Analogue Scale (VAS) was assessed before treatment, and in the 4th and 8th week after treatment. Results In both groups, VAS scores were significantly decreased after 4 and 8 weeks. The VAS score in US-SGB group was decreased from 5.44 ± 1.52 before treatment to 2.68 ± 1.33 at 4th week and to 1.32 ± 0.85 at 8th week after treatment, while in B-SGB group decreased from 5.36 ± 1.21 before treatment to 3.31 ± 1.27 at 4th week and to 2.09 ± 1.02 at 8th week after treatment. The alleviation of pain in US-SGB group was more significant than that in B-SGB group (4th week: t = 2.251, P = 0.038; 8th week: t = 1.971, P = 0.029). Conclusion Both US-SGB and B-SGB techniques were effective in relieving pain in breast cancer patients with neuropathic pain. However, with postoperative favorable clinical efficacy, US-SGB was better in pain relief in comparison with B-SGB.
Key words:
Nerve block,
Stellate ganglion,
Mastectomy, modified radical,
Neuralgia,
Ultrasonography, Doppler, color
刘成军, 蔡海峰, 刘殿臣, 刘延青, 孙志国, 李宁, 张娟, 张扬, 戴浩. 超声引导下星状神经节阻滞术治疗乳腺癌术后神经病理性疼痛[J]. 中国现代神经疾病杂志, 2013, 13(10): 872-875.
LIU Cheng-jun, CAI Hai-feng, LIU Dian-chen, LIU Yan-qing, SUN Zhi-guo, LI Ning, ZHANG Juan, ZHANG Yang, DAI Hao. Efficacy of ultrasound-stellate ganglion block in breast cancer with postoperative neuropathic pain[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(10): 872-875.