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感觉异常性股痛(股外侧皮神经卡压)

Author
Bruce C Anderson, MD
Section Editor
Jeremy M Shefner, MD, PhD
Deputy Editor
John F Dashe, MD, PhD

引言

股外侧皮神经是一单纯感觉神经，由于它从腰骶丛发出，行经腹腔，经腹股沟韧带下方，进入大腿的皮下组织，因此容易受到压迫。感觉异常性股痛，该术语用于描述与股外侧皮神经受压有关的股前外侧的疼痛、感觉异常或两者兼有的临床综合征[1]。 (参见“成人髋痛的评估”)

病因和流行病学

大部分感觉异常性股痛病例起因于股外侧皮神经在穿过腹股沟韧带下方时受到卡压。最常见的相关状况为肥胖、糖尿病和年龄较大[2]。其他相关情况还包括腹部凸出兼腹部脂膜过厚[3]、腰部腰带或衣物束缚过紧[4-6]、腹股沟韧带外侧面附近瘢痕组织以及妊娠[7-9]。

发生感觉异常性股痛的另一个重要原因为局部手术或区域性手术中的损伤(例如：脊柱手术、髂嵴取骨术、髋假体植入术、主动脉-双股动脉搭桥术)[10]；在一项纳入120例患者的病例系列研究中，该原因占17%[5]。机动车事故后的安全带伤是较为少见的原因[11]。已有报道称，长距离行走和骑行后也会发生股痛，这可能是由重复的肌肉拉伸过程中造成的局部缺血所致[12]。

在来自明尼苏达州的一项回顾性人群研究中，将262例感觉异常性股痛患者与262例体重指数与其匹配的对照者及262例正常对照者进行了比较[2]。该研究报道了以下观察结果：

  • 糖尿病人群中感觉异常性股痛的校正发病率是一般人群的7倍多(247/100,000人 vs 33/100,000人)
  • 在既存在感觉异常性股痛又有糖尿病的患者中，多数患者在股痛被诊断后发展出糖尿病
  • 与体重指数匹配的对照组相比，股痛患者明显更可能患有糖尿病(OR 2，95%CI 1.3-3.0)
  • 股痛患者的平均体重指数显著高于年龄和性别相匹配的对照组(30.1kg/m2 vs 27.3kg/m2)
  • 感觉异常性股痛患者诊断的平均年龄为50岁
  • 感觉异常性股痛男女发病率相似。

            

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Literature review current through: 2017-06 . | This topic last updated: 2016-12-01.
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