臂丛神经阻滞治疗脑损伤后肩手综合征的疗效

Effects of brachial plexus block for the treatment of shoulder-hand syndrome in patients after brain injury

目的 评价臂丛神经阻滞对脑损伤后肩手综合征的治疗效果.方法 脑损伤后肩手综合征患者42例,随机分为臂丛组（n=21）和常规组（n=21）.臂丛组用0.5％利多卡因行患侧臂丛神经阻滞;常规组予口服止痛药、局部理疗、针灸等常规方法治疗,两组的功能锻炼相同.治疗后2周用视觉模拟评分法（VAS）对肩手痛进行评分并评价疗效.结果 臂丛组优效率52.4％（11/21例）高于常规组14.3％（3/21例）（P＜0.05）,臂丛组有效率100％（21/21例）高于常规组85.7％（18/21例）（P＜0.05）;两组治疗后VAS评分均较治疗前降低（P＜0.05）;臂丛组治疗后VAS评分低于常规组（P＜0.05）.结论 臂丛神经阻滞用于治疗肩手综合征,可安全有效地控制患肢疼痛,有利于患肢的功能恢复.

Objective To observe the effects of brachial plexus nerve block in the treatment of shoulder-hand syndrome after brain injury. Methods Forty-two patients with shoulder-hand syndrome after brain injury were randomly divided into brachial plexus group and conventional treatment group with 21 cases in each group. Brachial plexus of diseased side was blocked with 0. 5% lidocaine in the brachial group. The patients in the conventional group received traditional methods of oral analgesics, physical therapy, acupuncture and other routine treatments. All patients in the two groups received the same rehabilitation exercises. Visual analogue scale （VAS） was observed two weeks after the treatment. Results Excellent effect in the brachial group was 52.4% （11/21 cases） and the conventional group was 14.3% （3/21 cases） （P〈0.05）. The effective rate in the brachial plexus group 100% （21/21 cases） was significantly superior to that in the conventional treatment group 85.7 % （18/21 cases）（P〈0.05）; VAS in the brachial plexus group was significantly lower than that in the conventional group after the treatment （P〈0.05） ; VAS in the brachial plexus group was significantly reduced after the treatment （P〈0.05）. Conclusion Brachial plexus block for the treatment of shoulder-hand syndrome can safely and effectively reduce the pain in shoulder and hand.