临床治疗臂丛神经痛的研究进展

Research Progress of Clinical Treatment in Patients with Brachial Plexus Pain

臂丛神经属周围神经,其疼痛性质属神经病理性疼痛,常继发于臂丛神经损伤、颈椎间盘病变、局部卡压及放疗后,疼痛剧烈,严重影响患者的生活质量。治疗及预后方面,药物保守治疗效果差且不良反应大,短-中频理疗效果不确定,脉冲射频虽安全但效果不持久,连续射频效果较好但并发症严重。目前临床上主要以保守治疗为主,故效果有限,微创介入镇痛术可望成为未来治疗臂丛神经痛的方向,克服射频并发症后推广有创连续射频热凝治疗符合这一趋势。

Brachial plexus belongs to peripheral nerve whose pain property is neuropathic pain,which is often secondary to brachial plexus injury/cervical disc protrusion/local tissue compression and postradiotherapy. Its pain is so severe which can affect the quality of life of the patients. As to its treatment and prognosis, conservative treatment has poor results which can result in adverse reaction. The physiotherapy of low-medium frequency has uncertain effect, and the pulsed radio fre- quency is safe but does not have long-term effect,while the continuous radio frequency has better effect but may cause seri- ous complications. For brachial plexus neuralgia, conservative treatment is still the main treatment at present and which has limited effect. Minimally invasive interventional analgesia is expected to become the direction of future treatment of brachial plexus neuralgia, and in my opinion, promoting continuous radiofrequency thermocoagulation after overcoming complications of continuous radio frequency is in line with this trend.