星状神经节阻滞联合体外冲击波治疗痉挛性斜颈的疗效观察

摘要

Objective To observe the curative effect of combination treatment of stellate ganglion block(SGB)and extracorporeal shock waves therapy(ESWT)for spasmodic torticollis(ST), Methods A total of 33 out - patients and in - pa-tients with ST in Shengjing Hospital Affiliated to China Medical University from March 2010 to August 2013 were selected as study subjects,the patients were randomly divided into control group(15 cases)and observation group(18 cases)on a voluntary ba-sis,control group received simple SGB treatment,observation group received combination treatment of SGB and ESWT,15 d was a course of treatment, The visual analogue scale(VAS)score and Tsui score 7 days,15 days,30 days,60 days after treat-ment were recorded,the curative effect was compared between two groups, Results There was no significant difference in VAS score and Tsui score between two groups before treatment(P > 0, 05);7 days,15 days,30 days and 60 days after treatment, VAS score in observation group was significantly lower than that in control groups(P < 0, 05);15 days,30 days and 60 days af-ter treatment,Tsui score in observation group was significantly lower than that in control group(P < 0, 05), After treatment, the numbers of remarkable effect,effect and inefficacy were 2,10 and 3 cases respectively in control group,the numbers of re-markable effect,effect and inefficacy were 12,6 and 0 cases respectively in observation group,the curative effect in observation group was better than that in control group(u = 3, 255,P = 0, 001), During SGB operation,1 case had brachial plexus block, 1 case had hoarse,1 case had dysphagia,the symptoms restored automatically 40 min later, Conclusion The curative effect of combination treatment of SGB and ESWT is better than that of simple SGB,combination treatment can relieve head and neck spastic pains early,and can improve muscular tension,range of motion(ROM)of cervical spine,stiffness and deflection symp-toms,the long - term effect is good.%目的：观察星状神经节阻滞（SGB）联合体外冲击波疗法（ESWT）治疗痉挛性斜颈（ST）的效果。方法选取2010年3月—2013年8月在中国医科大学附属盛京医院疼痛科门诊就诊及住院的 ST 患者33例，按照患者自愿原则分为对照组（15例）和观察组（18例），分别给予单纯 SGB 治疗及 SGB 联合 ESWT 治疗，连续应用15 d 为1个疗程。观察治疗后7、15、30、60 d 两组患者的视觉模拟量表（VAS）评分、Tsui 评分，比较两组的疗效。结果两组患者治疗前 VAS 评分及 Tsui 评分间无差异（P >0,05），治疗后7、15、30、60 d 观察组患者 VAS 评分均低于对照组（P <0,05），治疗后15、30、60 d 观察组患者 Tsui 评分低于对照组（P <0,05）。治疗后，对照组显效2例，有效10例，无效3例；观察组显效12例，有效6例，无效0例，观察组患者疗效优于对照组（u =3,255，P =0,001）。SGB操作时1例出现臂丛神经阻滞，1例出现声音嘶哑，1例出现吞咽困难，40 min 后均自行恢复。结论 SGB 联合 ESWT治疗 ST 效果优于单纯 SGB 治疗，能尽早缓解头颈部痉挛性疼痛，进一步改善肌张力、颈椎活动度、僵硬、偏斜症状，且不良反应小，远期效果佳。