超声引导下枕神经阻滞治疗颈源性头痛的临床疗效

目的探讨超声引导下枕神经阻滞在颈源性头痛治疗中的临床疗效。方法将48例颈源性头痛患者随机分成对照组和超声组，每组24例。对照组采用传统盲探操作行患侧枕神经阻滞，超声组采用超声引导下行患侧枕神经阻滞：两组均每周治疗1次，持续2周。比较两组患者穿刺成功率、穿刺次数、穿刺时间、治疗1周和1个月后的视觉模拟（VAS）评分及总有效率的差异。结果与对照组比较，超声组入路的实际穿刺深度和穿刺时间缩短，感觉阻滞增高，穿刺成功率增高，患者满意率增高，差异均有统计学意义（P〈0．05）。两组治疗后1周和1个月的VAS评分均较治疗前下降，治疗后1个月VAS评分较治疗后1周亦下降，但超声组较对照组下降更明显，差异均有统计学意义（P〈0．05）。两组患者均未发生严重并发症。结论超声引导下枕神经阻滞治疗颈源性头痛的方法明显优于传统盲探的治疗方法。

Treatment of cervicogenic headache by ultrasound-guided occipital nerve block

Objective To explore the value of ultrasound-guided occipital nerve block in treating refractoriness cervicogenic headache. Methods Forty-eight patients with cervieogenic headache were randomly divided into ultrasound group （n=24） and control group （n=24）. In ultrasound group,patients were treated by ultrasound-guided occipital nerve block. In control group, patients were treated by conventional occipital nerve block. In two groups, treatments were proceeded once a week and lasted 2 weeks. Puncture success rate, puncture times, puncture time, visual analogue score （VAS） and total effective rate were compared between the two groups. Results Compared with control group, puncture depth and puncture time decreased, feeling block, puncture success rate and patients satisfaction increased in ultrasound group （P〈0.05）. In two groups,VAS after treatment 1 week and 1 month was less than that before treatment. VAS after treatment 1 month was less than that after treatment lweek. VAS decrease of ultrasound group was more obvious than that of control group （P〈0.05）. Patients had not serious complications in two groups. Conclusion For refractoriness eervieogenie headache,the method by ultrasound-guided occipital nerve block is obviously superior to conventional method.