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临床医学论文-枕大神经痛的封闭治疗

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临床医学论文-枕大神经痛的封闭治疗

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

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.

Among these 12 cases, 5 cases were recovered after three times Results

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,多数病例在20 岁以上,无性别差异。用局部封闭

治疗枕大神经痛由来已久,经过几代人的努力,注射方法更加完善,注射部位更

加精确,注射药物配方更加科学,临床治疗效果不断提高。我们对临床上确诊为

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,

取得良好疗效,现总结报告如下。

1 材料与方法

1.1 临床资料 本组12 例,男4 例,女8 例。年龄21,65 岁,病程最

短3 h,最长半个月。疼痛位于一侧10 例,位于双侧2 例。疼痛部位主要位于

枕顶部,部分同时累及耳后。一般表现为持续性胀痛,有阵发性加剧。4 例疼痛

发作前有上呼吸道感染或局部受寒病史,6 例颈椎拍片显示:颈椎轻度退变,有前缘或后缘的轻度骨质增生,颈椎生理曲度变直,颈椎不稳等征象。发病以前有低头久

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