超声引导下竖脊肌平面阻滞治疗急性带状疱疹神经痛的临床疗效  

Clinical efficacy of ultrasound-guided erector spinae plane block for the pain management of acute herpes zoster neuralgia

作　　者：刘芳[1] 白志勇 路桂军 LIU Fang;BAI Zhi-Yong;LU Gui-Jun(Department of Pain Medicine,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Ultrasound,Beijing Tsinghua Changgeng Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院疼痛科,北京102218 [2]清华大学附属北京清华长庚医院,清华大学临床医学院超声科,北京102218

出　　处：《中国疼痛医学杂志》2021年第4期269-274,共6页Chinese Journal of Pain Medicine

摘　　要：目的:比较超声引导下竖脊肌平面阻滞(erector spinae plane block,ESPB)与胸椎旁神经阻滞(thoracic paravertebral block,TPVB)在治疗胸背部急性带状疱疹神经痛的疗效和安全性。方法:50例急性带状疱疹神经痛病人随机分为两组:超声引导下竖脊肌平面阻滞组和胸椎旁阻滞组,每组25例。两组病人均口服伐昔洛韦和加巴喷丁,记录阻滞前后的疼痛程度和睡眠质量、加巴喷丁用量、操作时间、操作疼痛分级、满意度和不良反应。结果:与治疗前相比,两组治疗后疼痛视觉模拟评分法(visual analogue scale,VAS)评分降低、睡眠质量(quality of sleep,QS)评分增加(P<0.01);与胸椎旁阻滞组相比,竖脊肌平面阻滞组操作时间短、操作疼痛分级低、满意度高(P<0.01),加巴喷丁用量无变化。结论:超声引导下竖脊肌平面阻滞和胸椎旁阻滞联合药物治疗急性带状疱疹神经痛均可达到较好疗效,竖脊肌平面阻滞操作简单安全、病人满意度更高。Objective:To compare the efficacy and safety of ultrasound-guided erector spinae plane block(ESPB)and thoracic paravertebral block(TPVB)for the pain management of acute herpes zoster neuralgia.Methods:Fifty patients suffering from pain caused by acute herpes zoster were randomly divided into ESPB and TPVB groups(n=25 each).Ultrasound-guided ESPB or TPVB were performed respectively in the two groups,combined with routine antivirus treatment and gabapentin as needed.The scales of pain and quality of sleep(QS)were monitored before and after the treatments.The consumption of gabapentin,length of the procedures,scale of pain during the procedures,patient satisfaction,and postoperative complications and adverse reactions were also compared between the two groups.Results:The visual analogue scale(VAS)scores were decreased and the QS scores were increased significantly in both groups after the treatments(P<0.01).Compared with TPVB group,the ESPB group showed significantly shorter procedure,greater change of scale of pain,and higher patient satisfaction(P<0.01).There was no significant difference between the two groups in the VAS,QS,and the consumption of gabapentin at each time point after the treatments.Conclusion:Ultrasound-guided ESPB and TPVB combined with oral medication are both effective for the pain management of acute herpes zoster neuralgia.Ultrasound-guided ESPB shows advantages over TPVB with greater patient satisfaction,and simpler procedure with shorter operation time.

关 键 词：带状疱疹 超声引导 竖脊肌平面阻滞 椎旁神经阻滞 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]