两种针具治疗锁骨上神经卡压综合征的临床疗效观察

目的：探讨铍针与普通针灸针2种针具治疗锁骨上皮神经卡压综合征的临床疗效。方法：2004年3月至2006年4月治疗200例锁骨上皮神经卡压综合征患者，分为铍针治疗组100例与针灸对照组100例，治疗组中男75例，女25例；年龄25～65岁，平均45岁；疗程3～7d。对照组中男60例，女40例；年龄16-63岁，平均35岁；疗程1～3个月。通过统计分析对铍针与针灸针的疗效进行比较。结果：随访6～12个月，平均9．6个月，治疗组中治愈79例，显效12例，好转8例，无效1例。针灸对照组中治愈43例，显效21例，好转17例，无效19例，两组疗效经秩和检验，T=1923．2，P〈0．05，差异有统计学意义。铍针治疗组治疗前软组织张力指数3．56±0．35，治疗后为2．11±0．41；针灸针治疗组治疗前软组织张力指数3．61±0.21，治疗后为3．13±0．56。两组疗后张力指数比较，P〈0．01，差异有统计学意义。结论：铍针能有效降低皮神经周围的压力，松解粘连，最后消除感觉末梢所受的刺激和压迫，迅速缓解疼痛。而一般针灸针治疗疗程长，治疗锁骨上皮神经卡压综合征铍针治疗的疗效优于一般针灸针治疗，起效快，便于临床推广。     

铍针治疗颈横皮神经卡压综合征

目的：探讨颈横皮神经卡压对颈部疼痛的影响及相应治疗方法。方法：对112例颈横皮神经卡压所致颈部疼痛的患者，采用铍针进行治疗，选取胸锁乳突肌后缘及颈椎棘突旁压痛点为进针点，并对治疗前后进行疗效评估。结果：112例患者平均随访16个月，其中治愈64例，显效36例，好转8例，无效4例，总有效率达97．15％。结论：颈横皮神经卡压可以导敛颈部疼痛，铍针治疗效果肯定。     

铍针治疗皮神经卡压性腰臀部疼痛的病例对照研究

目的:探索治疗皮神经卡压性腰臀部疼痛的安全有效的方法 ,明确铍针治疗皮神经卡压性腰臀部疼痛的指征。方法:自2003年1月至2004年12月选取皮神经卡压性腰臀部疼痛患者278例,分为铍针组和电刺激组。铍针组138例,男68例,女70例;年龄20~60(41.92±10.88)岁;电刺激组140例,男68例,女72例;年龄18~60(41.44±10.47)岁。治疗前后测量两组患者的疼痛、压痛,以及软组织张力情况,通过对比评价两种治疗方法的临床效果。结果:两组均未出现中止、剔除、脱落病例。治疗后铍针组疼痛评分由8.78±1.52下降为1.33±1.33,电刺激组由8.59±1.76下降为5.20±2.64,且治疗后铍针组疼痛评分低于电刺激组。治疗后铍针组压痛评分由9.12±1.24下降为1.60±1.36,电刺激组由8.79±1.60下降为5.34±2.60,且治疗后铍针组压痛评分低于电刺激组。结论:皮神经卡压综合征在形成明确的痛点、条索、结节时,铍针治疗为首选。     

铍针与推拿治疗胸外侧皮神经后支卡压综合征的临床对照试验

目的：比较铍针与推拿两种方法治疗胸外侧皮神经后支卡压综合征的临床疗效。方法：自2004年至2008年用铍针和推拿治疗胸外侧皮神经后支卡压综合征320例,随机分为铍针治疗组（治疗组）160例,推拿治疗组（对照组）160例。治疗组男105例,女55例;年龄26-66岁,平均（46．00±0．79）岁;疗程3-7d。对照组男98例,女62例;年龄19-64岁,平均（47．00±0．35）岁;疗程1-2个月。通过观察治疗前后软组织张力指数变化、局部疼痛和压痛情况进行疗效评定,经过统计分析对铍针与推拿的疗效进行比较。结果：随访7～12个月,平均10.3个月,据疗效评定标准,治疗组治愈119例,显效27例,好转12例,无效2例;对照组治愈73例,显效38例,好转40例,无效9例。两组疗效比较采用Wilcoxon秩和检验,U=3．184,P〈0．05,治疗组的疗效优于对照组。软组织张力指数治疗组治疗前平均（3．68±0．28）,治疗后（2．13±0．35）;对照组治疗前（3．59±0．22）,治疗后（3．17±0．19）。治疗后两组张力指数比较,t=4．781,P〈0．01,治疗组的张力指数低于对照组。结论：铍针能有效降低皮神经周围的压力,松解粘连,最后消除感觉神经末梢所受的刺激和压迫,迅速缓解疼痛。而推拿治疗疗程长,治疗胸外侧皮神经后支卡压综合征铍针治疗的疗效优于推拿治疗,起效快,便于临床推广。     

铍针治疗上肢皮神经卡压综合征的临床观察

上肢皮神经卡压综合征是由于现代人们长期伏案工作,上肢使用较多,致使局部组织劳损,上肢肌肉筋膜紧张,出现张力增高等病理改变,挤压刺激通过的皮神经,进而产生上肢疼痛等症状的综合征.为解决临床上经常出现的此类疾患,自2006年1月至2008年6月运用铍针疗法治疗上肢皮神经卡压综合征30例,疗效满意,报告如下.     

铍针治疗臀中皮神经卡压综合征

目的 :探讨在臀中皮神经卡压综合征中张力与疼痛的相关性 ,铍针减张治疗的有效性。方法 :用张力计测量铍针减张治疗臀中皮神经卡压综合征前后软组织的张力 ,并对软组织张力变化加以比较分析。结果 :经 1～ 12个月的随访 ,平均 6 3个月 ,其中治愈 2 1例 ,显效 6例 ,有效 3例 ,无效 2例 ,总有效率 93 75 %。所有患者治疗前测软组织张力指数为 3 14± 0 78,治疗后为 2 10± 0 93,经统计学处理治疗前后张力指数间的差异有非常显著意义 (P <0 0 1)。结论 :铍针可以切刺限制张力释放的纤维结缔组织如筋膜等 ,释放过高的筋膜腔内张力 ,或通过局部流体静压的调整缓解了对末梢神经的刺激     

铍针治疗股外侧皮神经卡压综合征

股外侧皮神经卡压综合征临床中并不少见，常常容易误诊，致使治疗效果欠佳。我院从2000—2004年采用铍针治疗股外侧皮神经卡压综合征47例，疗效满意，现总结报告如下。     

肩胛上神经卡压综合征的后入路手术应用

目的探讨手术治疗肩胛上神经卡压综合征的最佳人路。方法2000年1月～2003年6月．共收治肩胛上神经卡压综合征患者8例。男2例，女6例，年龄21～53岁。病程6个月～3年。均采用后入路切断肩胛上磺韧带松解肩胛上神经的手术方法。观察患者术后症状，肌力、肌肉萎缩的恢复情况。结果8例术后1周颈肩部疼痛均消失，肩外展、外旋及开始30。外展肌力恢复至5级．于术后1、6、12及16个月随访，症状未见复发，但肌肉萎缩无明显改善。结论后入路手术方法简便且不影响外形，肩胛￡神经卡压只局限在肩胛切迹处应选择后入路手术。     

铍针治疗隐神经髌下支卡压症86例

目的探讨隐神经髌下支卡压对膝关节疼痛的影响及相应的治疗方法.方法对86例因隐神经髌下支卡压引起膝关节疼痛的患者,采用铍针松解治疗,依据HSS膝关节评分标准对治疗前后进行疗效评估.结果 86例患者平均随访1.2年,治疗前HSS分值平均56.7分,治疗后85.4分;其中优23例,良46例,中14例,差3例,优良率80.2%.结论隐神经髌下支卡压症可以导致膝关节疼痛,铍针疗法疗效肯定.     

腓浅神经卡压综合征

目的：探讨腓浅神经卡压综合征的解剖学基础和手术方法。方法：对２例腓浅神经卡压综合征患者进行了手术治疗，并观测了６０侧成人腓骨下端的骨前嵴和３０侧尸体小腿标本。结论：“站立性”小腿、足背及踝前疼痛是腓浅神经卡压综合征的特征，是腓浅神经行至腓骨下端骨前嵴时遭受深筋膜或伸肌上支持带卡压所致。治疗方法是切开深筋膜或伸肌上支持带，将腓浅神经远离腓骨前嵴固定于皮下。     

Entrapment neuropathy of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome: a case report

A case of the entrapment neuropathy of the palmar cutaneous branch of the median nerve, concomitant with carpal tunnel syndrome is presented. This report demonstrates that the Semmes-Weinstein monofilament test and nerve conduction studies can identify entrapment of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome.     

腕管综合征与嗜酸性筋膜炎

目的 了解嗜酸性筋膜炎与腕管综合征的关系。方法 总结6例(男5例，女1例，平均年龄35．5岁)嗜酸筋膜炎合并腕管综合征的病例，就其发病机理，治疗及预后进行讨论。结果 4例行腕管切开，正中神经松解术，2例用药物治疗。治疗后患者的神经卡压症状缓解，全身症状消失。治疗后2例失访，4例随访14～38个月。患者全身症状及神经卡压症状均未复发。结论 由嗜酸性筋膜炎所致的腕管综合征与一般常见原因引起的腕管综合征不同，单纯手术减压效果不理想，需配合药物治疗方可缓解症状。     

The clinical features of,and microendoscopic decompression for,extraforaminal entrapment of the L5 spinal nerve

Objective: To evaluate the clinical results of, and surgical techniques for, microendoscopic (METRx) decompression of extraforaminal entrapment of the L5 spinal nerve at the lumbosacral tunnel. Methods: Five patients with extraforaminal entrapment of the L5 spinal nerve in the lumbosacral tunnel were treated in our department, including three men and two women. The average age was 65.6 years. All patients suffered severe leg pain and neurological deficits compatible with L5 radiculopathy. Minimally invasive decompression of the L5 spinal nerve was performed under METRx intertransverse decompression. Results: With an average follow‐up of 17.8 months, clinical results were assessed based on Nakai criteria and Visual Analogue scale (VAS). All patients experienced immediate pain relief postoperatively. Clinical outcomes were excellent in three patients and good in two. The average intraoperative blood loss was 59 ml, with an average operative time of 103 min. Average post‐operative stay in bed was 7 days, and average cost was $1860. Conclusion: Extraforaminal entrapment of the L5 spinal nerve in the lumbosacral tunnel can cause L5 radiculopathy. METRx partial resection of the L5 transverse processes, sacral ala and osteophytes of L5‐S1 vertebral bodies to relieve extraforaminal entrapment of the L5 spinal nerve is a very effective and minimally invasive surgical option.     

神经根型颈椎病伴有周围神经卡压的诊断和治疗

目的：研究29例双卡综合征的诊断和治疗。方法：从1997年以来同时诊断为神经根型颈椎病与周围神经卡压的病例中选出29例患者，诊断标准为：(1)影像学上存在神经根在椎管内受压的证据；(2)有临床和(或)电生理的证据表明存在周围神经受到卡压；(3)周围神经的Tine1征阳性。对其中5例行保守治疗，24例行手术治疗，即神经松解术。平均随访12个月，根据术后症状、体征改善的程度分优、良、可和无效4级。结果：25例治疗后疗效优良，占86％。结论：神经根型颈椎病伴有周围神经卡压的双卡综合征并不罕见，正确认识双卡综合征，对诜择正确的治疗方案和估计愈后有重要意义．一旦确诊．应采取手术或非手术相结合的方法，可以达到满意的效果。     

Anticoagulants and psoas hematoma

Between 1985 and 1989, 16 patients under anticoagulant therapy developed a haematoma in the psoas or iliac muscle, 60% of them with a severe femoral nerve entrapment syndrome. Six patients were operated, all with a femoral nerve paralysis, and 5 of them had a quick and complete recovery. Only one still has some complaints in the femoral nerve territory. Among the 10 patients with a nonoperative approach, none of those with a femoral nerve paralysis was completely cured at 6 months. The surgical treatment is the best way to a quick recovery, provided it is done at an early stage.     

Fibrous adhesive entrapment of lumbosacral nerve roots as a cause of sciatica.

STUDY DESIGN: Report of seven patients with fibrous adhesive entrapment of lumbosacral nerve roots as a cause of sciatica, whose radiographic findings were negative and who experienced relief from sciatica immediately after the entrapment was released. OBJECTIVES: To describe a new clinical entity of fibrous adhesive entrapment of lumbosacral nerve roots with negative radiographic findings. SETTING: Orthopaedic department, Japan. METHODS: Clinical evaluation and post-operative outcome in seven patients with entrapment of lumbosacral nerve roots because of fibrous adhesion confirmed intraoperatively. RESULTS: Radiographic examinations by magnetic resonance imaging (MRI), myelography, and computed tomographic (CT) myelography demonstrated neither disc herniations nor spinal stenosis in all seven patients, and differential nerve root block was effective for relieving sciatica and low back pain. We confirmed, intraoperatively, entrapment of the nerve root by fibrous adhesion, and all seven patients were relieved from sciatica and low back pain postoperatively. CONCLUSION: This study presented seven patients with sciatica caused by fibrous adhesive entrapment of lumbosacral nerve roots who underwent decompression and release of fibrous adhesion. Radiographic examinations, such as MRI, myelography and CT myelography, showed no compressive shadows and also differential nerve root block was effective for its diagnosis. This study seems to be the first report of patients with entrapment of lumbosacral nerve roots caused by fibrous adhesion, whose radiographic findings were negative.