中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
4期
429-431
,共3页
廖翔%蒋劲%熊东林%张强%肖礼祖%郑虎山%沙彤%梁豪文%罗裕辉%张德仁
廖翔%蔣勁%熊東林%張彊%肖禮祖%鄭虎山%沙彤%樑豪文%囉裕輝%張德仁
료상%장경%웅동림%장강%초례조%정호산%사동%량호문%라유휘%장덕인
神经节,脊%头痛%脉冲射频
神經節,脊%頭痛%脈遲射頻
신경절,척%두통%맥충사빈
Ganglia,spinal%Headache%Pulsed radiofrequency
本院2007年6月-2009年6月行颈2背根神经节脉冲射频术的颈源性头痛患者74例,年龄26～63岁,病程3个月-21年.术后随访18个月,行疼痛评分、生活质量参数(日常活动干扰参数、情绪干扰参数、睡眠干扰参数)评估,记录并发症发生情况和术后12、18月内头痛的复发情况.失访22例患者.与术前1 d时比较,术后VAS评分、日常活动干扰参数、情绪干扰参数、睡眠干扰参数降低(P＜0.05或0.01).部分患者在术后当晚出现一过性的枕神经支配区域不适,24 h内缓解.无颈髓损伤、椎动脉损伤和感染等并发症发生.术后12、18月内头痛复发率分别为19%、31%.
本院2007年6月-2009年6月行頸2揹根神經節脈遲射頻術的頸源性頭痛患者74例,年齡26～63歲,病程3箇月-21年.術後隨訪18箇月,行疼痛評分、生活質量參數(日常活動榦擾參數、情緒榦擾參數、睡眠榦擾參數)評估,記錄併髮癥髮生情況和術後12、18月內頭痛的複髮情況.失訪22例患者.與術前1 d時比較,術後VAS評分、日常活動榦擾參數、情緒榦擾參數、睡眠榦擾參數降低(P＜0.05或0.01).部分患者在術後噹晚齣現一過性的枕神經支配區域不適,24 h內緩解.無頸髓損傷、椎動脈損傷和感染等併髮癥髮生.術後12、18月內頭痛複髮率分彆為19%、31%.
본원2007년6월-2009년6월행경2배근신경절맥충사빈술적경원성두통환자74례,년령26～63세,병정3개월-21년.술후수방18개월,행동통평분、생활질량삼수(일상활동간우삼수、정서간우삼수、수면간우삼수)평고,기록병발증발생정황화술후12、18월내두통적복발정황.실방22례환자.여술전1 d시비교,술후VAS평분、일상활동간우삼수、정서간우삼수、수면간우삼수강저(P＜0.05혹0.01).부분환자재술후당만출현일과성적침신경지배구역불괄,24 h내완해.무경수손상、추동맥손상화감염등병발증발생.술후12、18월내두통복발솔분별위19%、31%.
Seventy-four patients aged 26-63 yr who had suffered cervicogenic headache for 3 months-21 yr were treated with puked radiofrequency applied to C2 dorsal root ganglion, which is located in the middle of the posterior side of lateral atlantoaxial joint. A trochar was introduced percutaneously under the guidance of X-ray aiming at the target point. As it was inserted through the deep fascia, the stylet was withdrawn and a 10 cm long 22 gauge curved blunt electrode was inserted into the trochar and advanced until the patients felt radiating pain from the point of puncture to occiput. Lateral radiograph was obtained to verify the placement of electrode. The tip of the electrode was usually located in front of spinal canal at the atlantoaxial joint level. Sensory stimulation was performed with 50 Hz and 0.1-0.5 V and the patients could feel radiating pain at occiput. Motor stimulation was performed with 2 Hz and 0.4-1.0 V and regular pulsation of the patient's muscle of occiput could occur. Pulsed radiofrequency was applied at 42 ℃7 for 240 s and was performed twice on each side. VAS scores and disturbances of daily activity, mood and sleep were recorded before operation and at 1 week and 1, 3, 6, 12 and 18 months after pulsed radiofrequency treatment. Complications and recurrence within 12 and 18 months were recorded. Follow-up was lost in 22 patients. VAS scores and disturbances of daily activity, mood and sleep significantly decreased after procedure. All of the patients responded without complications like infection, spinal cord and vertebral artery injury. Some patients had transient occipital neuralgia which was usually relieved within 24 h. The recurrence rate in 12 and 18 months after operation was 19% and 31% respectively.
