RESUMO
Objective:To analyze the efficacy and safety of ultrasound-guided intercostal nerve pulse radiofrequency combined with nerve block in the treatment of post-herpetic neuralgia.Methods:The clinical data of 62 patients with post-herpetic neuralgia who received treatment in The Affiliated Hospital of Southwest Medical University from May 2017 to May 2021 were retrospectively analyzed. These patients underwent nerve block (NB group, n = 30) or pulsed radiofrequency plus nerve block (PRF + NB group, n = 32). Before and after treatment, The Numerical Rating Scale (NRS) score and Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups. After treatment, the occurrence of complications including pneumothorax, infection, and skin numbness was evaluated in each group. Results:Before treatment, there were no significant differences in NRS and PSQI scores between the two groups (all P > 0.05). Immediately, 1 week and 1 month after treatment, there was no significant difference in PSQI score between the two groups (all P > 0.05). At 3 and 6 months after treatment, the NRS score in the NB +PRF group was (1.71 ± 0.35) points and (1.68 ± 0.36) points, which were significantly lower than (2.72 ± 0.68) points and (3.26 ± 0.76) points in the NB group ( t = 54.40, 78.18, both P < 0.05). There were no treatment-related complications such as pneumothorax, infection, nerve numbness, or muscle weakness in the two groups. Conclusion:Ultrasound-guided pulsed radiofrequency combined with nerve block has a definite curative effect on post-herpetic neuralgia and is highly safe. The medium- and long-term efficacy of the combined therapy is superior to that of nerve block alone.
RESUMO
Objective:To investigate the etiology, clinical manifestations, treatment methods, and prognosis of patients with iliopsoas muscle hematoma compressing the lumbar plexus.Methods:The clinical data of 11 cases of iliopsoas muscle hematoma oppressing the lumbar plexus nerve admitted to The Affiliated Hospital of Southwest Medical University between March 2014 and May 2018 were analyzed.Results:Eleven patients, consisting of 10 men and 1 woman, aged (36.36 ± 6.74) years were analyzed. Causes of iliopsoas muscle hematoma oppressing the lumbar plexus nerve included coagulation abnormality ( n = 8) and trauma ( n = 3). Iliopsoas muscle hematoma occurred on the left side in 7 cases and on the right side in 4 cases. Among them, 11 cases had bleeding in the middle area, 8 cases in the lower area, and 2 cases in the upper area. The involved lumbar plexus nerve included the femoral nerve ( n = 11), lateral femoral cutaneous nerve ( n = 6), and obturator nerve ( n = 2). Eleven cases underwent causative treatment ( n = 11). Three-month follow-up results showed that the hematomas were completely absorbed in 11 cases, and the bone and joint activities were normal. The sensory and motor functions were restored in 10 cases. The sensory function was restored, but the recovery of motor function was poor in 1 patient. All 11 cases returned to normal after 1 year. Conclusion:The main causes of iliopsoas muscle hematoma are coagulation dysfunction and trauma. The femoral nerve and lateral femoral cutaneous nerve in the lumbar plexus are easily affected, which can cause lower limb sensory and motor disorders. As for iliopsoas muscle hematoma caused by coagulation abnormality, coagulation factors should be supplemented to correct coagulation function. As for iliopsoas muscle hematoma caused by trauma, early surgical treatment should be performed to relieve nerve compression. Timely treatment of iliopsoas muscle hematoma can generally acquire a good prognosis.
