不完全性截瘫患者双下肢顽固性疼痛治疗1例及-第三军医大学学报.DOC

选择性神经根离断治疗截瘫患者顽固性疼痛11例及治疗进展 唐杰，汪洋，何忠诚，彭兴剑，柯珍勇 （400010 重庆，重庆医科大学附属第二医院骨科） 摘要：目的 探讨应用选择性神经根离断术治疗截瘫患者顽固性疼痛及疗效观察。 方法 采用选择性神经根切断治疗截瘫患者顽固性疼痛11例，通过术前、术后视觉模拟疼痛评分（VAS）及止痛药物的用量来评估疗效。结果 患者术前视觉模拟疼痛评分（VAS）8.2±0.8分，11例均需间断注射杜冷丁，术后1天患者疼痛明显缓解，视觉模拟疼痛评分（VAS）1.3±0.8分，无需使用止痛药物；术后1周，视觉模拟疼痛评分（VAS）3.5±0.7分，其中4例需间断口服止痛药物；术后1月，视觉模拟疼痛评分（VAS）3.4±0.7分，其中4例患者继续口服药物维持，其中1例需间断注射杜冷丁；术后3月，视觉模拟疼痛评分（VAS）3.7±0.8分，其中5例需间断口服止痛药物,2例需间断注射杜冷丁。 结论 选择性神经根切断是治疗截瘫患者顽固性疼痛的有效方法。 关键词：截瘫；顽固性疼痛；神经根切断；脊髓损伤 [中图法分类号] R683.2；R338.3；R744.9 [文献标志码] A [作者简介] 唐杰，男，硕士研究生，Tel420263359@ [通讯作者] 柯珍勇，TelE-mail：kzy6417@163.com Selective Partial Rhizotomy in the treatment of intractable pain due to paraplegia:11cases report and treatment progression. Tang Jie，Wang Yang,He Zhongcheng,Peng Xingjian,Ke Zhenyong(Department of Orthopedics，the Second Affiliated Hospital of Chongqing Medical University，Chongqing，400010，China ) [Abstract] Objective To explore an effective method of the treatment of intractable pain due to paraplegia. Methods 11 patients suffered with chronic and intractable pain due to paraplegia were treated with Selective Partial Rhizotomy, and postoperative therapeutic effects were observed by means of?visual?analogue scale (VAS) and the?dosage of analgesic drugs. Results the patients’ preoperative visual?analogue scale (VAS) were 8.2±0.8,and all the patients needed for injection Demerol discontinuously.The patients’ postoperative (1 day)?visual?analogue scale (VAS) were 1.3±0.8，and the patients needed no painkillers.The patients’ postoperative (1 week) visual?analogue scale (VAS) were 3.5±0.7，and 4 patients needed oral drugs discontinuously.The patients’ postoperative (1 month) visual?analogue scale (VAS) were 3.4±0.7，and 4 patients needed oral drugs discontinuously，1 patient needed for injection Tramadol discontinuously. The patients’ postoperative (3 months) ?visual?analogue scale (VAS) were3.7±0.8， and 5 patients needed oral drugs discontinuously，2 patients needed for i