不同部位电刺激治疗带状疱疹神经痛的疗效分析  

Analysis of outcomes for patients with zoster-related neuralgia in treatment of temporary stimulation dorsal nerve root and the spinal cord

作　　者：黄铭杰 黄佳彬 罗裕辉 高翃 梁豪文 熊东林 廖翔 张强 肖礼祖 HUANG Ming-Jie;HUANG Jia-Bin;LUO Yu-Hui;GAO Hong;LIANG Hao-Wen;XIONG Dong-Lin;LIAO Xiang;ZHANG Qiang;XIAO Li-Zu(Affiliated Shenzhen Sixth Hospital of Guangdong Medical University,Department of Pain Medicine,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,China)

机构地区：[1]广东医科大学附属深圳第六医院,华中科技大学协和深圳医院疼痛科,深圳518052

出　　处：《中国疼痛医学杂志》2021年第1期47-52,共6页Chinese Journal of Pain Medicine

基　　金：深圳市科创委学科布局(JCYJ20160429181451546)。

摘　　要：目的:对治疗带状疱疹神经痛(zoster-related neuralgia,ZRN)的短时程背根神经电刺激与脊髓电刺激两种方法的手术时间、放射暴露剂量、疗效及花费进行比较。方法:本文采用回顾性分析方法,对202例在DSA(digital subtraction angiography)引导下使用短时程电刺激治疗的带状疱疹神经痛病人(其中64例采用背根神经电刺激,138例采用脊髓电刺激),记录手术操作时间及每一例手术的辐射剂量,术后病人的程控次数,术前及术后1、2、3月等各时间段病人的疼痛程度,生活质量以及医疗耗材费等信息,并进行分析比较。结果:在3个月的随访期间,所有病人在两种方法治疗后疼痛视觉模拟评分法(visual analogue scale,VAS)评分和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PQSI)显著下降,而生活质量(SF-36健康调查简表)评分显著上升(P<0.01),且两种方法之间无统计学差异,然而背根神经电刺激病人的手术时间和术中辐射量明显少于脊髓电刺激组(P<0.05);且术后平均程控次数以及医疗耗材费用也明显少于脊髓电刺激组(P<0.05)。结论:短时程背根神经电刺激和脊髓电刺激都能有效治疗带状疱疹神经痛,但背根神经电刺激具有程控次数少、覆盖好、花费少等优点。Objective:To compare the procedure time,radiation doses,efficacy and the cost for patients with zoster-related neuralgia(ZRN)between treatment of temporary dorsal root stimulation(tDNRS)and temporary spinal cord stimulation(tSCS).Methods:In this retrospective analysis,a total of 202 patients with ZRN who were treated with tDNRS(n=64)and tSCS(n=138)under the guidance of digital subtraction angiography(DSA)was enrolled.The procedure time,radiation doses,number of modulation for postoperative patients,visual analogue scale(VAS),quality of life,and the cost of medical equipment were recorded and analyzed before procedure,after stimulation,and 1,2,and 3 months'follow-up.Results:The average score of VAS,Pittsburgh sleep quality index(PSQI)decreased significantly and the life quality(The MOS item short from healthy survey,SF-36)increased significantly after the treatment and at the time of 1,2 and 3 months'follow-up compared with the baseline for all the ZRN patients(P<0.01),there was no difference between the two groups.However,the procedure time and the radiation doses in patients with tDNRS were significantly less than those with tSCS(P<0.05),and the number of modulation and the cost of medical equipment in patients with tDNRS were significantly less than those with tSCS(P<0.05).Conclusions:Both tDNRS and tSCS can effectively relieve pain of ZRN patients,however,ZRN patients with tDNRS had the advantages of less modulations in therapeutic period,more comprehensive coverage,lower cost of medical equipment and so on.

关 键 词：带状疱疹神经痛 短时程脊髓电刺激 短时程背根神经电刺激 视觉模拟评分法 匹兹堡睡眠质量指数 SF-36健康调查简表 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]