神经阻滞复合氨酚羟考酮治疗急性颈源性头痛的临床疗效

Efficacy of neural blockade combined with oxycodone-acetaminophen on acute cervicogenic headache

目的:探讨曲安奈德行神经阻滞复合氨酚羟考酮口服治疗急性颈源性头痛的临床疗效及不良反应。方法:选择50例急性颈源性头痛患者,随机分为2组,每组25例,神经阻滞组应用曲安奈德配成利多卡因浓度为0.4%的消炎镇痛液,根据体征行枕大、枕小、耳大神经或颈2横突阻滞,每个穿刺点注射3 mL;复合治疗组行神经阻滞复合氨酚羟考酮片剂口服,0.5片,tid。对2组患者进行治疗前和治疗后的疼痛程度数字评分(NRS)和颈部活动度(ROM)的评价。结果:2组治疗后NRS和ROM较治疗前均明显改善(P<0.01)。与神经阻滞组比较,复合治疗组治疗1周后NRS和ROM改善明显(P<0.01和0.05),二次神经阻滞人数明显减少(P<0.05),且无明显不良反应发生。结论:神经阻滞复合氨酚羟考酮可进一步提高颈源性头痛的治疗效果。

Objective ： To investigate the efficacy and adverse effects of neural blockade using triamcinolone combined with oxycodone-acetaminophen on acute cervicogenic headache （CEH）. Methods： Fifty patients with acute CEH were randomly divided into 2 groups. The patients were treated with occipital neural blockade and C2 neural blockade by triamcinoloue combined with a mixture of 0.4% lidocaine （neural blockade group） ; or treated with neural blockade combined with oxycodone-acetaminophen in a regimen of 0.5 tablet tid （combination group）. After the blockade, the pain degree （numeric rating scales, NRS） , and the degree of cervical stiff measured by restriction of the range of motion of the neck （ROM） were observed. Results： NRS decreased and ROM improved significantly after the treatments in 2 groups （P 〈 0.01 ）. The NRS and ROM were significantly improved, and the need of the second blockade was significantly decreased 1 week after neural blockade in combination group as compared with neural blockade group. Conclusion： Neural blockade combined with oxycodone-acetaminophen is more effective in the treatment of CEH.