超声引导下周围神经脉冲射频治疗老年带状疱疹后神经痛回顾性分析  

Retrospective analysis of clinical efficacy of ultrasound-guided peripheral nerve pulse radiofrequency and nerve block in the treatment of elderly patients with postherpetic neuralgia

作　　者：孙琳[1] 杨晓秋[1] 李南[1] 周泽军[1] 左蕾[1] SUN Lin;YANG Xiao-Qiu;LI Nan;ZHOU Ze-Jun;ZUO Lei(Department of Pain,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院疼痛科,重庆400016

出　　处：《中国疼痛医学杂志》2020年第12期912-916,共5页Chinese Journal of Pain Medicine

基　　金：重庆市卫健委卫生适宜技术推广项目(2019jstg045)。

摘　　要：目的:探讨彩色超声引导下周围神经脉冲射频(peripheral nerve pulse radiofrequency, PR)与周围神经阻滞(peripheral nerve block, PL)治疗老年带状疱疹后神经痛(postherpetic neuralgia, PHN)病人的临床疗效及原因分析。方法:回顾性分析老年PHN病人79例,分为PL组(周围神经阻滞治疗)59例,PR组(周围神经脉冲射频治疗)20例。记录两组治疗前后给予镇痛药物及抗惊厥药物情况、治疗前后、出院时、出院1周及1月后疼痛数字评分法(numerical rating scale, NRS)评分、治疗后出院前有无再次给予神经阻滞治疗、治疗并发症。结果:两组镇痛药物用量、出院时及治疗后NRS评分比治疗前有显著降低(P <0.05),PR组出院1周后及1个月后NRS评分较PL组显著降低(P <0.05)。两组间治疗前及治疗后镇痛药剂量、治疗后及出院时NRS评分无统计学差异。结论:超声引导下周围神经脉冲射频与周围神经阻滞治疗老年病人PHN均可使镇痛药物剂量明显减少,疼痛评分下降,且安全无严重并发症,但周围神经脉冲射频治疗PHN远期疗效更佳。Objective: To evaluate the clinical effect of ultrasound-guided peripheral nerve pulse radiofrequency(PR) and peripheral nerve block(PL) in the treatment of elderly patients with postherpetic neuralgia. Methods: A total of 79 patients diagnosed with PHN were divided into two groups, 59 cases in PL group, 20 cases in PR group were included. Patients in PL group were successfully treated with ultrasound-guided peripheral nerve block during hospitalization, while patients in PR group were successfully treated with ultrasound-guided peripheral nerve pulse radiofrequency. The therapeutic effects were evaluated by numerical rating scale(NRS) before and after treatment, on discharge, one week and one month after discharge. The doses of analgesic and anticonvulsant drugs were also evaluated before and after the treatment. The additional nerve blocking and complications treatment given after treatment were also recorded. Results: The dose of analgesic drugs and NRS scores at discharge and after treatment in the two groups were significantly lower than those before treatment(P < 0.05), NRS of PR group at on one week and one month after discharge was significantly lower than that of PL group(P < 0.05), while there were no significant differences in the doses of analgesic and anticonvulsant drugs, NRS scores after treatment and at discharged between the two groups. Conclusion: Ultrasound-guided peripheral nerve pulse radiofrequency and peripheral nerve block can significantly reduce the dosage of analgesic drugs, reduce pain score, and have no serious complications in the treatment of elderly patients with postherpetic neuralgia. Long-term curative effect of ultrasound-guided peripheral nerve pulse radiofrequency in the treatment of elderly patients with postherpetic neuralgia is better.

关 键 词：带状疱疹后神经痛 周围神经脉冲射频 神经阻滞 老年 

分 类 号：R752.12[医药卫生—皮肤病学与性病学] R747.9[医药卫生—临床医学]