超声引导下颈2神经根阻滞改善颈源性头痛患者头颈僵硬感及颈椎活动度的效果

Effect of ultrasound guided C2 nerve root block on head and neck stiffness and cervical mobility in patients with cervicogenic headache

目的 探讨超声引导下C_2神经根阻滞改善颈源性头痛(Cervicogenic headache, CEH)患者头颈僵硬感及颈椎活动度的效果。方法 选择2021年1月—2022年6月本院收治的113例CEH患者作为研究对象,随机数表法分为C_2神经根阻滞组(57例)和药物治疗组(56例)两组。两组均予以双氯芬酸钠缓释胶囊治疗,同时为C_2神经根阻滞组联用超声引导下C_2神经根阻滞治疗。对比两组患者的颈椎活动度、头痛程度及头痛对日常生活的影响程度。结果 研究期间两组患者的ROM评分及VAS评分逐渐降低,且治疗后及1个月后随访C_2神经根阻滞组ROM评分及VAS评分低于药物治疗组,差异具有统计学意义(P<0.05);治疗后,C_2神经根阻滞组头痛对日常生活产生轻度影响患者比例高于干预前及干预后药物治疗组,其头痛对日常生活产生显著影响患者比例低于干预前及干预后药物治疗组,差异具有统计学意义(P<0.05);一个月后随访时,两组头痛对日常生活产生轻度影响患者比例高于治疗前及治疗后,头痛对日常生活产生显著影响患者比例低于治疗前及治疗后,差异具有统计学意义(P<0.05);一个月后随访时,C_2神经根阻滞组头痛对日常生活产生轻度影响比例高于药物治疗组,差异具有统计学意义(P<0.05)。结论 超声引导下C_2神经根阻滞可有效改善CEH患者头颈僵硬感并增加其颈椎活动度,同时该疗法还可缓解头痛并减轻头痛对其日常生活的影响。

Objective To investigate the effect of C2 nerve root block guided by ultrasound on head and neck stiffness and cervical mobility in patients with cervicogenic headache(CEH).Methods 113 patients with CEH who got treatment in our hospital from January 2021 to June 2022 were enrolled in the study.According to random number table method,they were randomly divided into C2 nerve root block group(57 cases)and drug treatment group(56 cases).Patients in both groups were treated with diclofenac sodium sustained-release capsules,while C2 nerve root block group were treated with C2 nerve root block guided by ultrasound.The degree of cervical motion,headache degree and the influence of headache on daily life were compared between the two groups.Results During the study period,the ROM score and VAS score of the two groups decreased gradually,and the ROM score and VAS score of the C2 nerve root block group were significantly lower than those of the drug treatment group after treatment and one month at follow-up(P<0.05).After treatment,the proportion of patients with headache having a slight impact on daily life in the C2 nerve root block group was significantly higher than that before treatment,as well as that in the drug treatment group;the proportion of patients with headache having a significant impact on daily life in the block group was lower than that in before intervention and that in the drug treatment after the intervention,the differences were statistically significant(P<0.05).During the follow-up at one month later,the proportion of patients with headache having a slight impact on daily life was higher than that before and after treatment,and the proportion of patients with headache having a significant impact on daily life was lower than that before and after treatment(P<0.05).During the follow-up at one month later,the proportion of headache with mild impact on daily life in the C2 nerve root block group was higher than that in the drug treatment group,the difference was statistically significant(P<0.05).Conclusions C2 nerve root block under ultrasound guidance can effectively improve head and neck stiffness and increase cervical mobility in CEH patients.At the same time,this therapy can also alleviate headache and reduce the impact of headache on their daily life.