超音波導引下於正中神經四面象周圍使用脈衝式高頻熱凝療法獲致意外長期療效

Impressive Treatment of Complex Regional Pain Syndrome with Pulsed Radiofrequency for the Median Nerve in Four Aspects under Ultrasound Guidance

複雜區域性疼痛症候群對病患之生活品質造成相當大的影響，對於醫師而言也非常具挑戰性。星狀神經節阻斷與低位頸椎交感神經阻斷術傳統上常被用於上肢複雜區域性疼痛症候群之第一線診短與治療。然而，此案例報告中一位上之複雜區域性疼痛症候群（第二型）四十八歲男性患者，在使用其他治療方法皆數失敗後，接受超音波導引下之正中神經脈衝式高頻熱凝療法，爾後在兩年觀察期內獲得相對長期之滿意治療效果。

Complex regional pain syndrome (CRPS) has always been quite a clinical challenge to doctors, as it gravely affects the patients’ quality of life. Stellate ganglion/lower cervical sympathetic block has been traditionally advocated for first-line diagnostic, therapeutic and prognostic purposes for CRPS of the upper extremities. However, in this case report, we found that after multiple failed treatment attempts, pulsed radiofrequency (RF) thermocoagulation of the median nerve under real-time ultrasound guidance yielded relatively long-term satisfactory effects on a 48 y/o male with upper limb CRPS type II during a follow-up period over 24 months.