硬膜外自控镇痛联合更昔洛韦治疗患者带状疱疹神经痛的效果  

Efficacy of patient-controlled epidural analgesia combined with ganciclovir for treatment of postherpetic neuralgia

作　　者：金文哲[1] 任婷婷[1] 李仁淑[1] 张广建[1] 邱德来[2] 

机构地区：[1]延边大学附属医院疼痛科,133000 [2]延边大学细胞研究中心延边大学医学部生理学与病理生理学教研室

出　　处：《中华麻醉学杂志》2014年第8期965-967,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价硬膜外自控镇痛联合更昔洛韦治疗患者带状疱疹神经痛的效果.方法 带状疱疹神经痛患者60例,年龄51 - 86岁,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为2组（n=30）：更昔洛韦组（F组）和硬膜外自控镇痛联合更昔洛韦组（FB组）.FB组和F组静脉滴注更昔洛韦0.25 g,2次/d,连续滴注7d,FB组同时采用自控镇痛泵进行持续硬膜外镇痛（配方：罗哌卡因300 mg＋氢化泼尼松龙20 mg＋地佐辛10 mg＋生理盐水至250 ml）.于患者治疗前1 d（T0）和治疗后7 d（T1）、1个月（T2）和6个月（T3）时记录视觉模拟评分（VAS评分）、生存质量评分（QOL评分）和T1-3时疼痛缓解情况.结果 与T0时比较,两组患者T13时VAS和QOL评分降低（P＜0.05）;与F组比较,FB组T13时VAS评分降低,QOL评分和疼痛缓解率升高（P＜0.05）.结论 硬膜外自控镇痛联合更昔洛韦可有效缓解带状疱疹神经痛.Objective To evalvate the efficacy of patient-controlled epidural analgesia （PCEA） combined with ganciclovir for treatment of postherpetic neuralgia in patients.Methods A total of 60 patients with PHN,aged 51-86 yr,of ASA physical status Ⅰ-Ⅲ,were randomly assigned into 2 groups （n =30 each） using a random number table：ganciclovir group （F group） and PCEA combined with ganciclovir group （FB group）.In FB and F groups,ganciclovir 0.25 g was infused intravenously twice a day for 7 consecutive days.In addition,continuous PCEA was performed simultaneously in group FB and the PCEA solution contained ropivacaine 300 mg,prednisolone 20 mg and dezocine 10 mg in 250 ml of normal saline.At 1 day before treatment （T0） and 7 days,1 month,and 6 months after treatment （T1-3）,pain was assessed with visual analogue scale （VAS）,and the quality of life （QOL） score and pair relief rate were recorded.Results VAS and QOL scores were significantly lower at T1-3 than at T0 in the two groups.Compared with F group,VAS scores were significantly decreased,and QOL score and pain relief rate were increased at T1-3 in FB group.Conclusion PCEA combined with ganciclovir can effectively alleviate postherpetic neuralgia in the patients.

关 键 词：神经痛 疱疹 带状 镇痛 硬膜外 更昔洛韦 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]