摘要
目的探讨水疗联合局部封闭治疗常见周围神经损伤后顽固疼痛的临床疗效和安全性。方法选取2017年12月~2019年8月收治35例周围神经损伤后顽固疼痛的患者。将其随机分为单纯局部封闭组和水疗联合局部封闭组,单纯局部封闭组所用药物为利多卡因注射液、甲钴胺注射液和复方倍他米松注射液的混合液(1∶1∶1),水疗联合局部封闭组在局部封闭治疗24 h后患肢在四肢分离电水浴槽进行直流脉冲电刺激气泡水疗。周围神经疼痛采用疼痛视觉模拟评分量表(VAS)评价。观察两组疼痛部位的疼痛改善情况及不良反应发生情况。结果与治疗前相比,治疗4周后两组患者疼痛程度均有明显改善(P<0.05),与单纯局部封闭组比较,水疗联合局部封闭组疼痛改善明显(P<0.05)。单纯局部封闭组患者接受治疗后总有效率为97.1%,水疗联合局部封闭组总有效率为100.0%,但组间比较差异无统计学意义(P>0.05)。1例治疗3次后VAS评分为7分,后期进行手术治疗,治疗期间所有患者均未出现明显不良反应。结论水疗联合局部封闭治疗可有效缓解常见周围神经损伤后顽固疼痛,疗效优于单纯局部封闭治疗,安全性好,值得临床推广应用。
Objective To explore the clinical efficacy and safety of the hydrotherapy and local occlusive therapy in the treatment of intractable pain after common peripheral nerve injury.Methods Thirty-five patients with intractable pain after peripheral nerve injury from December 2017 to August 2019 were admitted.They were randomly divided into the local occlusive group and the hydrotherapy combined with local occlusive group.The drugs used for local occlusion were a mixture of lidocaine injection,mecobalamin injection and compound betamethasone injection(1∶1∶1).After 24 hours of local occlusive treatment,the affected limb in the hydrotherapy combined with local occlusive group was subjected to direct current pulse electric stimulation bubble hydrotherapy in the limb separated electric water bath.Peripheral nerve pain was evaluated by visual analogue scale(VAS).The pain improvement in the painful area and the occurrence of adverse reactions between the two groups were observed.Results After 4 weeks of treatment,the pain level of the two groups was significantly improved compared with that before treatment(P<0.05).The pain in the hydrotherapy combined with local occlusive treatment group was significantly better than that in the local occlusive treatment group(P<0.05).After treatment,the total effective rate in the simple local closure group was 97.1%,while the total effective rate in the hydrotherapy combined with local occlusive treatment group reached 100.0%,but there was no significant difference between the two groups(P>0.05).One case had a VAS score of 7 after treatments for 3 times,and surgery was performed in the later period.During the treatment,no obvious adverse reactions occurred in all patients.Conclusion Hydrotherapy combined with local occlusive therapy can effectively alleviate intractable pain after common peripheral nerve injury.Its curative effect is better than that of simple local occlusive therapy.It is safe and worthy of clinical application.
作者
高锋
程瑞动
刘正
GAO Feng;CHENG Ruidong;LIU Zheng(Yuyao People's Hospital in Zhejiang Province,Yuyao315400,China;Zhejiang Provincial People's Hospital,Hangzhou310000,China)
出处
《中国现代医生》
2020年第30期105-107,111,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018KY228)。
关键词
水疗
局部封闭
周围神经损伤
顽固疼痛
Hydrotherapy
Local occlusive
Peripheral nerve injury
Intractable pain
