肩胛上神经联合喙突下臂丛神经阻滞治疗肩周炎的临床应用

Suprascapular nerve combined with subcoracoid brachial plexus blocks for treatment of scapulohumeral periarthritis

目的观察肩胛上神经联合喙突下臂丛神经阻滞治疗肩周炎的临床效果。方法选择疼痛门诊肩周炎患者57例,阻滞药物均为1%利多卡因。于患侧阻滞肩胛上神经,无不良反应后即于同侧行喙突下臂丛神经阻滞。均隔日阻滞1次,3次为1疗程。观察记录治疗前、后的VAS评分,同时记录两组患者治愈、显效、有效、无效例数及不良反应。结果与治疗前比较,第1次至第3次治疗后的VAS评分均显著降低（P〈0.05）;与第1次治疗后比较,第3次治疗后的VAS评分亦显著降低（P〈0.05）;第1次和第2次治疗后的VAS评分差异无统计学意义（P〉0.05）;全组治愈率82.5%（47/57例）,总有效率94.7%（54/57例）;均未见不良反应发生。结论肩胛上神经联合喙突下臂丛神经阻滞治疗肩周炎可取得满意的临床疗效。

Objective To observe the clinical effect of suprascapular nerve combined with subcoracoid braehial plexus blocks to treat scapulohumeral periarthritis. Methods Fifty-seven patients with scapulohumeral periarthritis were selected. Suprascapular nerve of affected side was blocked with 1% lidocaine, then the subcoracoid brachial plexus block was blocked if there was no adverse reactions. 1 time treatment per two days and 3 times for a treatment a course. VAS were recorded before and 1 month, 6 months, 12 months after treatment. The cure, significant, effective, ineffective rates and adverse reactions were recorded. Results The VAS after treatment of 1st time to 3rd time was significantly lower than that before treatment （P〈0.05）; the VAS after treatment of 3rd time was significantly lower than that the 1st time after treatment （ P〈0.05 ） ; The VAS of 1st time and 2nd time after treatment was no significant difference （ P〉 0. 05 ） ; the total cure rate and total effective rate were 82.5% （47/57 cases） and 94.7% （54/57cases） respectiveily. No adverse reactions occurred. Conclusion Suprascapular nerve combined with subcoracoid brachial plexus blocks is satisfactory efficacy for treatment of scapulohumeral periarthritis.