枕大神经痛的封闭治疗【荐】.docVIP

枕大神经痛的封闭治疗 作者：单军标，徐华梓 摘要：目的 通过对12具成人头颈部尸体标本的解剖，对临床上确诊为枕大神经痛的12 例病人，在枕大神经行程中易卡压的部位，进行局部封闭治疗，观察治疗结果。方法 根据病因在不同部位用2％利多卡因5 mL、确炎舒松A30 mg混悬液进行局部封闭治疗。对有颈椎劳损退变的病人(本组6 例)，进行第2颈椎横突内后方入肌点进行封闭；对有感冒及遭受风寒侵袭者进行枕大神经浅出皮下点封闭(本组4 例)；对有外伤引起者(本组2 例)，行上述两处封闭，并同时予枕颌带牵引。随访观察治疗效果。结果 本组12 例，注射后疼痛完全消失，随访3个月无复发5 例，占41.5％。注射后疼痛大部分消失6 例，占50％。注射后症状无明显改善1 例，占8.5％。结论 局部封闭治疗枕大神经痛，只要注射部位准确，注射方法得当，可以取得良好疗效。 关键词：枕大神经痛；应用解剖；封闭 The Applied Anatomic Meaning of Great Occipital Nerve SHAN Junbiao1， XU Huazi2 (1. Department of Orthopaedics， the People′s Hospital of Dongyang City， Zhejiang Dongyang 322100， China； 2. Department of Orthopaedics， 2nd Affiliated Hospital of Wenzhou Medical College， Zhejiang Wenzhou 310000， China) Abstract： Objective To investigate the clinical treatment effects of great occipital neuralgia with local injection according to applied anatomic study. Methods 12 cases of great occipital neuralgia were reviewed. According to different causes of great occipital neuralgia， 2％ lidocaine and triamcinolone were injected locally at different point. 6 cases which were caused by cervical vertebra strain and nonstationary were injected at the point where the great occipital nerve exactly pass into the muscles in the innerrear of the second cervical vertebra transverse process. 4 cases which were caused by fever were injected at the exit point where the great occipital nerve pass through subcutaneously. 2 cases which were caused by injury were injected at both above points. Results Among these 12 cases， 5 cases were recovered after three times of injections， 6 cases were improved greatly and only one case get nothing improvement after 3～5 times of injections. Conclusion The treatment of great occipital neuralgia with local injection can get satisfactory effects so far as it were applied correctly with the right way and at the right point. Key words： great occipital neuralgia； applied anatomic； local injection 枕大神经痛发病年龄广，多