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1.
目的 观察超声引导下局部神经阻滞治疗腰三横突综合征的疗效。 方法 采用随机数字表法将78例腰三横突综合征患者分为观察组及对照组,每组39例。2组患者均给予日常生活指导、超短波、中频电疗及推拿治疗;观察组患者在此基础上辅以超声引导下神经阻滞治疗,对照组则辅以常规徒手定位神经阻滞治疗。于治疗前、治疗2周后分别采用视觉模拟评分法(VAS)、距离测量法对2组患者疼痛情况及腰前屈活动范围进行评定,并对比2组患者临床疗效结果。 结果 治疗2周后2组患者疼痛VAS评分及腰前屈活动范围均较治疗前明显改善(P<0.05),并且观察组患者疼痛VAS评分[(1.8±0.4)分]、腰前屈活动范围[(69.4±14.4)cm]及愈显率(94.8%)均显著优于对照组水平,组间差异均具有统计学意义(P<0.05)。 结论 与徒手定位神经阻滞比较,在常规干预基础上辅以超声引导下神经阻滞能进一步缓解腰三横突综合征患者疼痛,改善腰部活动功能。  相似文献   

2.
目的 比较放射式体外冲击波与超声引导下神经阻滞治疗足底筋膜炎的临床疗效。方法 40例门诊足底筋膜炎患者按治疗方式分为放射式体外冲击波治疗组(S组)和超声引导下神经阻滞治疗组(U组)各20例。两组分别在治疗前及治疗第1、2、4、8周,采用视觉模拟评分法(VAS)判断疼痛程度。采用足功能指数量表(FFI)评估治疗前及治疗第1、2、4、8周足部疼痛及功能变化,观察两组治疗过程中出现的不良反应。结果 与治疗前比较,两组治疗后第1、2、4、8周VAS评分均有显著下降(P均<0.05),且U组治疗第1、2、4周VAS评分较S组下降明显(P<0.05);U组治疗第1、2、4、8周后FFI总分、活动受限评分较S组显著下降(P均<0.05),治疗第2、4周后FFI疼痛评分较S组下降明显(P<0.05),治疗第4、8周后FFI残疾评分较S组下降显著(P<0.05);两组未出现出血、感染、过敏等严重不良反应。结论两种治疗方式均可有效治疗足底筋膜炎,且在治疗8周内超声引导下神经阻滞疗效优于放射式体外冲击波治疗。  相似文献   

3.
目的:探讨超声引导下胸椎旁阻滞联合加巴喷丁对难治性胸背痛患者疼痛程度的影响。方法:选取2019年1月~2021年1月收治的难治性胸背痛患者86例为研究对象,按照随机数字表法分为常规组和实验组,各43例。常规组给予加巴喷丁治疗,实验组在常规组基础上给予超声引导下胸椎旁阻滞治疗。对比两组临床疗效,治疗前、治疗第1周、治疗第2周、治疗第3周、治疗第4周疼痛程度、加巴喷丁用量及并发症发生情况。结果:实验组治疗总有效率为90.70%(39/43),高于常规组的72.09%(31/43)(P<0.05);实验组治疗第1周、治疗第2周、治疗第3周、治疗第4周疼痛程度评分较常规组低(P<0.05);实验组治疗第1周、治疗第2周、治疗第3周、治疗第4周加巴喷丁使用剂量较常规组低(P<0.05);实验组并发症发生率为13.95%(6/43),与常规组的20.93%(9/43)比较,差异无统计学意义(P>0.05)。结论:超声引导下胸椎旁阻滞联合加巴喷丁治疗难治性胸背痛临床效果显著,可有效减轻患者疼痛程度,减少加巴喷丁使用剂量,安全性高。  相似文献   

4.
目的:探讨超声引导下星状神经节置管连续阻滞对神经血管性头痛的疗效及安全性。方法:选取2020年7月至2022年6月河南大学第一附属医院收治的80例神经血管性头痛患者,按照随机数字表法分为对照组与研究组,各40例。对照组给予常规药物治疗,研究组在对照组基础上给予超声引导下星状神经节置管连续阻滞治疗。对比两组临床疗效、治疗前后疼痛情况、炎症反应、生活质量及不良反应。结果:研究组治疗总有效率(95.00%)较对照组(75.00%)更高(P<0.05);治疗后,研究组疼痛视觉模拟评分(VAS)、医学结局研究用疼痛量表(MOSPM)评分及疼痛频率较对照组更低(P<0.05);治疗后,研究组血清白细胞介素(IL)-4、IL-6及C反应蛋白(CRP)水平较对照组更低(P<0.05);治疗后,研究组生活质量调查简表(SF-36)评分较对照组更高(P<0.05);两组不良反应总发生率均为5.00%,差异无统计学意义(P>0.05)。结论:对神经血管性头痛患者采用超声引导下星状神经节置管连续阻滞治疗可有效改善其疼痛情况,减轻炎症反应,提高生活质量,疗效确切且安全性良好。  相似文献   

5.
目的:探究短时程脊髓电刺激联合臭氧对神经病理性疼痛患者机械痛阈值、疼痛程度以及炎症因子的影响。方法:选取2021年2月至2023年1月我院收治的神经病理性疼痛患者90例。将90例NP患者根据随机数字表法分为研究组(n=45)和对照组(n=45),对照组在X线透视引导下植入电极进行短时程脊髓电刺激(tSCS)治疗,连续治疗2周;研究组在对照组的基础上联合臭氧治疗,予疼痛触发点行臭氧注射,每周2次,共治疗2周。记录并比较两组机械痛阈值、视觉模拟评分(VAS),检测两组肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(interleukin 6,IL-6)表达水平,评价两组治疗后的临床疗效。结果:治疗后,研究组总有效率为82.22%(37/45),对照组总有效率为62.22%(28/45),差异有统计学意义(P<0.05);治疗后,两组患者机械痛阈值明显升高(P<0.05),且研究组的机械痛阈值明显高于对照组(P<0.05);两组治疗后VAS评分以及血清TNF-α、IL-6水平显著降低(P<0.05),且研究组明显低于对照组(P<0.05)。结论:短时程脊髓电刺激联合臭氧能有效治疗神经病理性疼痛,提升患者的机械痛阈值,缓解患者疼痛,并降低血清炎症因子水平。  相似文献   

6.
【摘要】目的:探讨核心肌力训练联合呼吸训练对慢性下背痛疼痛及腰功能障碍的作用。方法:选取我院于2021年1月-2021年12月收治的84例慢性下背痛患者为研究对象,以随机数字表法分成对照组(n=42)和观察组(n=42),均施以核心肌力训练,观察组在此基础上联合呼吸训练,比较两组视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)量表评分、腰椎屈曲范围、腰椎多裂肌横截面积(CSA)及腹横肌厚度。结果:训练后,观察组VAS评分、ODI评分、腰椎屈曲活动范围(ROM)高于对照组,左右两侧CSA、腹横肌厚度均高于对照组,差异有统计学意义(P<0.05)。结论:对慢性下背痛患者实施核心肌力训练联合呼吸训练,可明显减轻疼痛程度,改善腰椎功能,扩大腰椎屈曲范围,增强腰椎神经肌肉控制能力。  相似文献   

7.
电刺激双耳后乳突部治疗椎动脉型颈椎病的TCD和BAEP观察   总被引:1,自引:1,他引:1  
目的:观察电刺激治疗椎动脉型颈椎病患者的经颅多普勒超声(TCD)和脑干听觉诱发电位(BAEP)变化,从血流速度及神经电生理角度探讨电刺激双耳后乳突部的作用机制。方法:将40例椎动脉型颈椎病患者随机分为电刺激组和常规组,电刺激组加例,常规组20例,与30例健康人对照组比较。治疗前及治疗2周后检查TCD及BAEP.观察电刺激治疗对椎动脉型颈椎病患者血流速度及脑电生理的影响。结果:治疗前电刺激组与常规组椎基底动脉(VBA)流速明显低于对照组(P〈0.05)。TCD异常的比例为75%(30/40例),以VBA流速降低为主要特点。BAEP异常的比例为77.5%(31/40例),以脑干型异常为主。治疗后两组血流速度均有改善,与常规组比较,电刺激组椎动脉流速改善更显著(P〈0.05)。治疗后两组神经传导功能均有改善,与常规组相比,电刺激组Ⅴ波的峰潜伏期(PL)、Ⅲ-Ⅴ和Ⅰ-Ⅴ波的峰间潜伏期改善更显著(P〈0,05)。结论:电刺激双耳后乳突部可改善椎动脉型颈椎病椎基循环的血流速度及脑干神经传导功能。  相似文献   

8.
目的 观察体外冲击波治疗慢性非特异性下背痛(CNLBP)的临床疗效。 方法 采用随机数字表法将64例CNLBP患者分为观察组及对照组,每组32例。2组患者均给予常规康复干预(如干扰电、超声波治疗等),观察组在此基础上辅以体外冲击波治疗,连续治疗2周。于治疗前、治疗2周后分别采用疼痛视觉模拟评分(VAS)、Roland-Morris下背痛功能障碍调查表(RMDQ)及36条目简明健康调查量表(SF-36)对2组患者疼痛、腰部功能障碍程度及生活质量进行评定。 结果 治疗后2组患者疼痛VAS评分、RMDQ评分及SF-36评分均较治疗前明显改善(P<0.05);并且观察组上述疗效指标评分[分别为(2.77±1.76)分、(7.5±5.4)分、(92.8±19.2)分]亦显著优于对照组水平,组间差异均具有统计学意义(P<0.05)。 结论 在常规康复干预基础上辅以体外冲击波治疗能进一步改善CNLBP患者腰痛症状及腰椎功能,提高患者生活质量,该联合疗法值得临床推广、应用。  相似文献   

9.
【目的】探析超声联合神经刺激仪引导下闭孔神经阻滞在经尿道膀胱癌电切术中的应用及安全性。【方法】择期行经尿道膀胱肿瘤电切术治疗的患者75例,按随机数字表分为观察组( n =39)对照组( n=36)。对照组于超声引导下进行闭孔神经阻滞,观察组于超声联合神经刺激仪引导下行闭孔神经阻滞。比较两组1次、2次穿刺成功率、阻滞起效时间、操作时间、麻醉相关时间、闭孔神经阻滞成功率及血管损伤发生率。【结果】观察组1次穿刺成功率、闭孔神经阻滞成功率分别为100.0%(39/39)、97.4%(38/39),高于对照组的88.9%(32/36)、83.3%(30/36),且两组相比较差异均有显著性( P <0.05);两组2次穿刺成功率与血管损伤发生率相比较差异无显著性( P >0.05)。观察组起效时间、操作时间及麻醉相关时间均短于对照组( P<0.05)。【结论】超声联合神经刺激仪引导下闭孔神经阻滞在经尿道膀胱癌电切术中应用可有效提高闭孔神经阻滞成功率,且简单易行、定位准确、阻滞完善、操作安全,为闭孔神经阻滞有效方法,值得推广应用。  相似文献   

10.
张勃欣  闵若谦 《中国康复》2014,29(5):379-380
目的:探索适合民航乘务员下背痛的康复治疗方案。方法:患有下背痛的乘务员80例,分为对照组28例、观察A组25例及观察B组27例。对照组仅接受下背痛相关健康教育及腰背部锻炼的指导。观察组别在此基础上给予中频电疗、高频电疗及腰椎牵引等治疗。观察A组每周治疗1次,观察B组每2周治疗1次。治疗前、治疗1及3个月时采用下背痛症状的视觉模拟评分(VAS)及简明疼痛评估(BPI)评定3组疗效。结果:治疗1个月时,观察A、B组的VAS及BPI评分均有所下降,但差异无统计学意义;治疗3个月后,观察A组VAS及BPI评分较治疗前、治疗1个月时及对照组和观察B组均明显下降(P<0.05),其余各组、各时间点的VAS及BPI评分均差异无统计学意义。结论:中频电疗、高频电疗及腰椎牵引治疗的康复治疗组合,可在每周1次的治疗频率,持续3个月后改善民航乘务员下背痛症状。该方案可在机场周边建立实施,为解决民航乘务员下背痛提供思路。  相似文献   

11.
经皮神经电刺激结合运动疗法治疗脑卒中后肩痛的疗效观察   总被引:11,自引:1,他引:11  
目的观察经皮神经电刺激(TENS)结合运动疗法治疗脑卒中后肩痛的疗效。方法将60例脑卒中后肩痛患者分为2组,治疗组30例,采用TENS合并运动疗法治疗;对照组30例,采用单纯TENS治疗。采用疼痛的视觉模拟评分法(VAS)和Fugl-Meyer评估量表进行疗效评定。结果治疗组在减轻疼痛、增加肩关节活动范围、增加患侧上肢运动功能方面明显优于对照组(P〈0.01)。结论TENS合并运动疗法治疗脑卒中后肩痛具有满意疗效。  相似文献   

12.
OBJECTIVES: To assess the effect of acupoint stimulation with electrodes combined with acupressure using an aromatic essential oil (lavender) as an add-on-treatment on pain relief and enhancing the physical functional activities among adults with sub-acute or chronic non-specific low back pain. DESIGN: Randomised controlled trial. SETTING: The community centre, Old-Aged Home and Women Workers Association, Hong Kong. Intervention: 8-session relaxation acupoint stimulation followed by acupressure with lavender oil over a 3-week period. The control group received usual care only. OUTCOME MEASURES: Changes from baseline to the end of treatment were assessed in pain intensity (by Visual Analogue Scale) and duration; lateral fingertip-to-ground distance in centimetres; walking time and interference on daily activities. RESULTS: The baseline VAS scores for the intervention and control groups were 6.38 (S.E.M. = 0.22) and 5.70 (S.E.M. = 0.37) out of 10, respectively ( P=0.24 ). One week after the end of treatment, the intervention group had 39% greater reduction in VAS pain intensity than the control group ( P=0.0001 ), improved walking time ( P=0.05 ) and greater lateral spine flexion range ( P=0.01 ). CONCLUSIONS: Our results show that 8-sessions of acupoint stimulation followed by acupressure with aromatic lavender oil were an effective method for short-term LBP relief. No adverse effects were reported. To complement mainstream medical treatment for sub-acute LBP, the combined therapy of acupoint stimulation followed by acupressure with aromatic lavender oil may be one of the choices as an add-on therapy for short-term reduction of LBP.  相似文献   

13.
OBJECTIVE: To investigate the outcomes resulting from the use of fluoroscopically guided therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain. DESIGN: Retrospective study with independent clinical review. A total of 15 patients who met specific physical examination or electrodiagnostic criteria and failed to improve clinically after at least 4 wks of physical therapy were included. Each patient demonstrated a positive response to a fluoroscopically guided cervical selective nerve root block. Therapeutic selective nerve root blocks were administered in conjunction with physical therapy. Outcome measures included visual analog scale pain scores, employment status, medication usage, and patient satisfaction. RESULTS: Patients' symptom duration before diagnostic injection averaged 13.0 mos. An average of 3.7 therapeutic injections were administered. Follow-up data collection transpired at an average of 20.7 mos after discharge from treatment. An overall good or excellent outcome was observed in three patients (20.0%). Among those treated without surgery, a significant reduction (P = 0.0313) in pain score was observed at the time of follow-up. Six patients (40.0%) proceeded to surgery. CONCLUSIONS: These initial and preliminary findings do not support the use of therapeutic selective nerve root block in the treatment of this challenging patient population with traumatically induced spondylotic radicular pain.  相似文献   

14.
目的探讨经皮神经电刺激对弛缓型脑瘫患儿的临床疗效及表面肌电变化。方法 40例弛缓型脑瘫患儿分为治疗组(n=20)和对照组(n=20),两组均接受30 d的常规康复训练,治疗组另外对股四头肌进行经皮神经电刺激治疗,每周5次,治疗30d。治疗前后按改良Lovett肌力测定法进行股四头肌肌力测定(Lovett分级),粗大运动功能测试量表(GMFM)评定患儿粗大运动发育情况,同时运用表面肌电仪测定股四头肌自主收缩位表面肌电积分值(iEMG)和表面肌电信号均方根值(RMS)的变化。结果治疗后两组脑瘫患儿的Lovett分级、GMFM评分、iEMG和RMS均较治疗前改善(P<0.05),且治疗组优于对照组(P<0.05)。结论经皮神经电刺激有利于提高弛缓型脑瘫患儿股四头肌肌张力,增强肌力,改善运动功能。  相似文献   

15.
Median nerve somatosensory evoked potentials (SEPs) were monitored in patients with chronic pain before and after stellate ganglion blockade. A change caused by the syndrome or by the block would suggest that SEPs might be useful in the diagnosis and treatment of chronic pain. We observed 20 subjects. Group I (n = 10) had chronic pain not involving the upper extremity. Group II (n = 8) had reflex sympathetic dystrophy of the arm. All patients underwent unilateral stellate ganglion block using an anterior paratracheal approach. The SEPs were recorded by median nerve stimulation on the blocked (affected) side and unblocked (unaffected) side before and 30 min after the block. Recording sites were ipsilateral brachial plexus, the cervical spinal cord, and the contralateral sensory cortex. There were no between-group differences before or after the block. Paired analysis within each group showed that the SEPs were not different from baseline (unaffected side before block) at any time throughout the study. We conclude that since SEPs are not changed by the reflex sympathetic dystrophy or stellate ganglion block, they would not be useful in the evaluation of pain or in determining the effectiveness of sympathetic block. Both the pain and the block appear to involve alteration of conducting pathways separate from those monitored by median nerve SEPs.  相似文献   

16.
神经阻滞用于急性单纯骨折病人的术前镇痛   总被引:1,自引:0,他引:1  
目的比较观察骨折病人做神经阻滞镇痛和哌替啶肌注镇痛的效果.方法将107例骨折病人分两组,A组采用骨折后肌注哌替啶1mg/kg(n=55);B组在骨折后采用相应部位的神经阻滞镇痛(n=52),分别记录治疗后10,30,60min时的VAS值和并发症.结果B组治疗后30min无痛率为19%,而B组为4%,显效率B组54%.A组27%,两组间比较无痛率和显效率均为B组高于A组,P<0.01,有非常显著的差异.治疗后1h无痛率A组和B组分别为5%和23%,显效率分别为39%和58%,两组间比较无痛率和显效率B组高于A组,P<0.05,有显著差异.B组恶心呕吐发生率明显低于A组.结论对骨折创痛病人应用神经阻滞法解除骨折创痛,其效果优越于肌注哌替啶,且并发症少.  相似文献   

17.
目的:探讨C臂机引导下选择性神经阻滞治疗老年性腰腿痛的临床疗效。方法:老年性腰腿痛患者246例纳入观察组,给予C臂机引导下的选择性神经阻滞;老年性腰腿痛患者200例纳入对照组,给予传统借助解剖标志及异感法进行的神经阻滞。术后随访18个月,观察2组治疗前后视觉模拟评分(VAS)及Mac Nab腰椎痛手术评价的差异。结果:2组治疗后VAS评分均降低,均低于同组治疗前(P0.05),且观察组明显低于对照组(P0.01);观察组总有效率96.7%,对照组总有效率76%,差异有统计学意义(P0.01)。结论:C臂机引导下选择性神经阻滞治疗老年性腰腿痛疗效显著。  相似文献   

18.
OBJECTIVE: To evaluate the efficacy of 8 hours of continuous low-level heatwrap therapy for the treatment of acute nonspecific low back pain (LBP). DESIGN: Prospective, randomized, parallel, single-blind (investigator), placebo-controlled, multicenter clinical trial. SETTING: Five community-based research facilities. PARTICIPANTS: Two-hundred nineteen subjects, aged 18 to 55 years, with acute nonspecific LBP. INTERVENTION: Subjects were stratified by baseline pain intensity and gender and randomized to one of the following groups: evaluation of efficacy (heatwrap, n=95; oral placebo, n=96) and blinding (oral ibuprofen, n=12; unheated back, wrap n=16). All treatments were administered for 3 consecutive days with 2 days of follow-up. MAIN OUTCOME MEASURES: Primary: day 1 mean pain relief (0- to 5-point verbal response scale). Secondary: muscle stiffness (101-point numeric rating scale), lateral trunk flexibility (fingertip-floor distance), and Roland-Morris Disability Questionnaire over 3 days of treatment and 2 days of follow-up. RESULTS: Heatwrap therapy was shown to provide significant therapeutic benefits when compared with placebo during both the treatment and follow-up period. On day 1, the heatwrap group had greater pain relief (1.76+/-.10 vs 1.05+/-.11, P <.001), less muscle stiffness (43.1+/-1.21 vs 47.6+/-1.21, P=.008), and increased flexibility (18.6+/-.44 cm vs 16.5+/-.45 cm, P=.001) compared with placebo. Disability was also reduced in the heatwrap group (5.3 vs 7.4, P=.0002). Adverse events were mild and infrequent. CONCLUSION: Continuous low-level heatwrap therapy was shown to be effective for the treatment of acute, nonspecific LBP.  相似文献   

19.
目的 :神经妥乐平 (neurotropin ,NTP)是家兔皮肤接种牛痘病毒后局部炎症皮肤中提取的生物活性物质 ,本研究旨在观察该药及与神经阻滞疗法联合应用治疗腰椎间盘突出致根性坐骨神经痛的临床效果。方法 :CT或MRI证实的腰椎间盘突出、并有单侧坐骨神经痛的患者 10 2例 ,分 (1)神经阻滞组 (NB ,n =4 5 ) :骶管注射 +L2~ 5椎旁注射 ,每周 1次 ,连续 5周 ;(2 )神经阻滞 +神经妥乐平组 (NB +NTP组 ,n =35 ) :骶管注射 +L2~ 5椎旁注射同NB组 ,每周 1次 ,2周后骶管内追加NTP 6ml,其余同以往治疗 ,在行神经阻滞治疗间隙每天肌肉注射 3ml神经妥乐平。 5周治疗结束后进行疗效评价 ,并观察其中 16例患者治疗前后肌电图的变化 ;(3)神经妥乐平组 (NTP ,n =2 2 ) :前 2周仅给予口服非甾体类消炎止痛药物 (如莫比可、英太青 ) ,2周后开始予神经妥乐平 6ml/d肌肉注射共 2周 ,最后 1周改为 3ml/d肌注 ,比较治疗前后的疼痛缓解情况。结果 :(1)单独使用神经妥乐平可以明显缓解腰椎间盘突出引起的坐骨神经痛 (P <0 .0 5 ) ;(2 )神经妥乐平不仅能明显提高神经阻滞疗法缓解根性坐骨神经痛的作用 ,两者联合应用 ,还可明显缓解神经根受压所致的下肢麻木 (P <0 .0 1) ;(3)除极少数病例出现皮肤过敏反应 ,NTP用于治疗坐骨神经痛无  相似文献   

20.
OBJECTIVES: To verify the dose-response relationship in phenol nerve block and to determine the concentration and volume of phenol injectate required for effective nerve conduction block. DESIGN: Before-after, experimental study. SETTING: A research institute laboratory. ANIMALS: Seventy-one New Zealand white rabbits. INTERVENTIONS: Group I (n = 48) received tibial nerve block by perineural injection (phenol, n = 40; saline, n = 8), group II (n = 21) by submerging the nerve in phenol solution. The 6 subgroups of group I each received different concentrations (3%, 4%, 5%) and volumes (0.1mL, 0.2mL, 0.3mL). The 2 subgroups of group II received 3% (n = 8) and 5% (n = 13) phenol. MAIN OUTCOME MEASURES: Compound muscle action potential (CMAP) and tension of triceps surae muscles by electric stimulation of the sciatic nerve were measured preintervention and at day 1, and weeks 1, 2, 4, and 8 postblock. Histologic studies were performed on 2 animals from group I. RESULTS: Two rabbits in group I died before results were obtained. In the remaining animals, CMAP amplitude reduced significantly (p <.05) as the volume of 5% phenol solution increased from 0.1mL, 0.2mL, to 0.3mL. A high concentration of phenol produced a more pronounced conduction block; however, no significant (p =.0589) difference existed among the 3 concentrations. Submerged tibial nerve had a greater degree of conduction block than perineurally injected nerve. Depth of the degeneration area in nerve fascicle varied with distance from the injection point. CONCLUSIONS: The nerve block effect of phenol can be titrated by adjusting the concentration and volume of phenol solution if the technique of application and localization of a block site are standardized.  相似文献   

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