亚甲蓝椎旁神经阻滞治疗下肢RSD及CRPS疗效分析.docVIP

亚甲蓝椎旁神经阻滞治疗下肢RSD及CRPS疗效分析【摘要】 目的 比较常规治疗加用亚甲蓝椎旁神经阻滞治疗下肢RSD及CRPS的临床效果。方法 将在我院疼痛门诊椎旁神经阻滞治疗的2007年10月至2008年10月共6例下肢RSD及CRPS患者随机分为A、B两组;椎旁神经阻滞药物A组:布比卡因+舒芬太尼+亚甲蓝+强的松,B组:布比卡因+舒芬太尼+强的松。两组患者均按同一方式进行椎旁神经阻滞,根据效果决定治疗间隔。评估治疗效果采用视觉模拟评分(VAS)。结果 6例患者均进入结果分析,整个治疗过程完整。A组1次/2W,B组2次/W。组间比较差异显著。结论 两组总疗效均有改善,加用亚甲蓝后需要治疗间隔明显较长。 【关键词】 亚甲蓝;椎旁阻滞;RSD及CRPS Paravertebral nerve block methylene blue treatment of lower extremity RSD/CRPS efficacy analysis SHI Jianhua.Anesthesia,The First People’s Hospital of Yangquan city(Yangquan,Shanxi045000,China 【Abstract】 Objective Increase compared paravertebral nerve block using methylene blue treatment of lower extremity RSD/CRPS clinical effect.Methods Pain in our hospital outpatient treatment paravertebral nerve block from October 2007 to October 2008 a total of six cases of lower limb RSD/CRPS patients were randomly divided into A,B group;paravertebral nerve block drug A:Bupivacaine+Sufentanil+methylene blue+prednisone,B group:bupivacaine+sufentanil+prednisone.The two groups are the same way in patients with paravertebral nerve block,in accordance with the treatment effect of the decision interval.Assessment of treatment using visual analogue score(VAS).Results 6 patients entered the final analysis,the whole integrity of the treatment process.A Group 1/2W,B Group 2/W.Difference between groups significant.Conclusion The total effect of the two groups have improved,the need to increase after treatment with methylene blue significantly longer interval. 【Key words】 Methylene blue; Paravertebral block 根据美国国立神经疾病和中风研究所的定义,交感神经反射障碍症Reflex Sympathetic Dystrophy(RSD)和复杂区域疼痛综合征Complex Regional Pain Syndrome(CRPS)的多个临床征状包括区域神经性疼痛、血流量出现不正常的调节及多汗、水肿、皮肤及附属组织出现营养改变,以及主动及被动性移动障碍。我院疼痛门诊治疗的6例下肢CRPS患者均为确诊病例。 1 资料与方法 A组患者男1例,女2例,平均年龄53岁。左下肢1例,右下肢2例。发病时间5个月~1年。B组患者男1例,女2例,平均年龄51岁。左下肢2例,右下肢1例。发病时间6个月~1年。A组用药为:亚甲蓝30 mg布比卡因37.5 mg舒芬太尼100 mg强的松40 mg、维生素B??12?1500 μg,注射用水稀释至15 ml。B组用药为:布比卡因37.5 mg舒芬太尼100 mg强的松40 mg、维生素B??12?1500 μg,注射用水稀释至15 ml。两组均采用直