髂腹股沟神经皮肤分布区的临诊观察及神经痛诊治的解剖学基础(系列报道之十一)

Clinical observation of cutaneous distribution of the ilioinguinal nerve and the anatomical bases of diagnosis and treatment of its neuralgia

目的 介绍髂腹股沟神经在大阴唇皮肤分布区的临诊观察及神经痛的诊断与局部注射的治疗方法 方法 选择门诊确诊为髂腹股沟神经痛或股后皮神经痛累及其会阴支的女性患者共28人计31侧,细查计刺痛觉的变化以确定诊断及两神经分布区的范围 采取强的松龙25mg+2％利多卡因或1％普鲁卡因5～10ml注射最大可能致病部位 结果 注射后数分钟检查麻醉范围。证实分布区及诊断无误,21人23侧髂腹股沟神经痛患音,除2例未接受治疗以外,皆经1次注射后疼痛短时间内完全消失,绝大多数1周后痊愈,极少数经第2次注射后痊愈,个别失访 结论 女性31侧髂腹股沟神经在大阴唇的分布区可确定为前2/3者25例(80.65％),前1/2者4例(12.9％),前1/3者2例(6.45％),一般教科书无细载 对神经痛的治疗,采取局部注射强的松龙的方法,可以获得满意的疗效。

Objective To introduce the clinical olwer, ation of cutaneous distribution of the ilioinguinal nerve on the labia major and diagnosis and local injection treatment of its neuralgia. Methods 31 cases of 28 patients diagnosed as ilioinguinal nerve neuralgia or the perineal brainch, long posterior labial nerve of the posterior femoral cutaneous nerve neuralgia were selected in out patient department. The distributive territory of the nerve was determined by needle test to the pain sensation. .After the diagnosis was certained, prednisolone plus local anesthetic was injected to the suspected part w'here the nerve might be entrapped. Results All the 23 cases of ilioinguinal neuralgia, besides 2 cases refused treatment, pain were stopped few minutes after injection. The distributive area was confirmed again by needle test. Most of them recovered one week later. A (ew of them recovered after two injections. Conclusion The distributive area (if the ilioinguinal nerve on the labia majora of total 31 cases. 25 cases cxru-py the anterior 2/3(80.65% ) ,4 cases occupy the anterior 1/2 ( 12.9% ), 2 cases occupy the anterior 1/3 (6.45% ). There is no such detailed description on the general textbooks. Local injection of prednisolone is the one of methods for treating the neuralgia. Best effect could be obtained.