枕大神经痛的封闭治疗

The Applied Anatomic Meaning of Great Occipital Nerve

目的通过对12具成人头颈部尸体标本的解剖,对临床上确诊为枕大神经痛的12例病人,在枕大神经行程中易卡压的部位,进行局部封闭治疗,观察治疗结果。方法根据病因在不同部位用2%利多卡因5mL、确炎舒松A30mg混悬液进行局部封闭治疗。对有颈椎劳损退变的病人(本组6例),进行第2颈椎横突内后方“入肌点”进行封闭;对有感冒及遭受风寒侵袭者进行枕大神经“浅出皮下点”封闭(本组4例);对有外伤引起者(本组2例),行上述两处封闭,并同时予枕颌带牵引。随访观察治疗效果。结果本组12例,注射后疼痛完全消失,随访3个月无复发5例,占41.5%。注射后疼痛大部分消失6例,占50%。注射后症状无明显改善1例,占8.5%。结论局部封闭治疗枕大神经痛,只要注射部位准确,注射方法得当,可以取得良好疗效。

Objective To investigate the clinical treatment effects of great occipital neuralgia with local injection according to applied anatomic study. Methods 12 cases of great occipital neuralgia were reviewed. According to different causes of great occipital neuralgia, 2% lidocaine and triamcinolone were injected locally at different point. 6 cases which were caused by cervical vertebra strain and nonstationary were injected at the point where the great occipital nerve exactly pass into the muscles in the inner-rear of the second cervical vertebra transverse process. 4 cases which were caused by fever were injected at the exit point where the great occipital nerve pass through subcutaneously. 2 cases which were caused by injury were injected at both above points. Results Among these 12 cases, 5 cases were recovered after three times of injections, 6 cases were improved greatly and only one case get nothing improvement after 3-5 times of injections. Conclusion The treatment of great occipital neuralgia with local injection can get satisfactory effects so far as it were applied correctly with the right way and at the right point.