超声引导下射频热凝治疗残肢断端神经瘤疼痛的疗效

Efficacy of radiofrequency thermocoagulation under ultrasound guidance in the treatment of pain in stump neuroma

目的 观察超声引导下射频热凝治疗残肢断端神经瘤疼痛的临床效果.方法 选择残肢断端神经瘤疼痛患者6例,在超声引导下穿刺进入残肢断端神经瘤内进行阻抗测定(400Ω～550 Ω),确认在神经瘤内,局部麻醉5 min后进行射频热凝治疗,射频温度设置从60 ℃开始,时间90 s一个间隔,然后逐次升温10℃,直到90℃.以超声观察治疗前后神经瘤变化,并记录术后3d、1周、1个月时疼痛评分及药物使用情况.结果 与治疗前相比较瘤体明显缩小;治疗后3d、1周、1个月时VAS评分均降到3以下(P＜0.05),优良率均为100％;患者均停止使用镇痛药.结论 超声引导下射频热凝治疗残肢断端神经瘤疼痛疗效确切.

Objective To observe the efficacy of radiofrequency thermocoagulation under ultrasound guidance in the treatment of pain in stump neuroma.Methods Six patients with pain in stump neuroma were enrolled in the study.The impedances were detected (400 Ω～550 Ω) when the needle was punctured into the neuroma under ultrasound guidance.Radiofrequency thermocoagulation was proceeded five minutes after local anesthetics.The temperature started from 60 ℃,lasted for 90 s,then successively increased 10 ℃ with another 90 s,until the temperature rised to 90 ℃.The changes of neuroma before and after the treatment were confirmed by ultrasound.VAS and the dosage of analgesic drugs were recorded at 3 days,1 week,and 1 month after the treatment.Results The neuroma shrank in 6 patients immediately after the treatment.VAS was below 3 in all of the patients after the treatment (P＜ 0.05) and the excellent and good rate was 100％ at 3 days,1 week,and 1 month after the treatment.All patients stopped using analgesic.Conclusion Radiofrequency thermocoagulation under ultrasound guidance is effective in the treatment of pain in stump neuroma.