经皮穿刺三叉神经节富血小板血浆注射治疗三叉神经带状疱疹后神经痛的临床效果  

Effect of percutaneous injection of platelet-rich plasma into the trigeminal ganglion for treatment of patients with trigeminal postherpetic neuralgia

作　　者：田德民[1] 高晓明[1] 杨磊 王晓明[1] 段斌斌 张健来 鞠衍馨 Tian Demin;Gao Xiaoming;Yang Lei;Wang Xiaoming;Duan Binbin;Zhang Jianlai;Ju Yanxin(Department of Painology,Weihai Municipal Hospital,Shandong University,Weihai City,Shandong Province 264200,China;Department of Anesthesiology,970th Hospital of the PLA,Yantai City,Shandong Province 264100,China)

机构地区：[1]威海市立医院疼痛科,威海市264200 [2]解放军联勤保障部队第九七〇医院麻醉科,烟台市264100

出　　处：《中华疼痛学杂志》2022年第1期52-57,共6页Chinese Journal Of Painology

摘　　要：目的观察经皮穿刺三叉神经节注射富血小板血浆(PRP)治疗三叉神经带状疱疹后神经痛(PHN)的临床效果。方法收集2019年3月至2020年10月威海市立医院疼痛科收治的头面部三叉神经PHN患者21例,男12例,女9例,年龄53~82岁,病史1~13个月。局部麻醉下经皮穿刺至三叉神经节,分别于三叉神经节及卵圆孔单次注射血小板富集度(5.7±1.1)倍的PRP各0.5 ml。观察并记录治疗前、治疗后1、7、15、30及90 d时患者数字等级评分(NRS)评分及无痛、轻、中及重度疼痛患者例数;记录术后并发症发生情况。结果21例患者均顺利穿刺成功并完成治疗。治疗后1、7、15、30及90 d时患者NRS评分分别为[4.0(2.0)、3.0(1.5)、2.0(2.0)、1.0(1.0)和0(2.5)]分,均较治疗前的7.0(2.0)分显著降低(P均<0.05)。治疗后90 d时,仅有2例中度疼痛患者、没有重度疼痛患者,均较治疗前的6例中度疼痛和15例重度疼痛显著减少,差异有统计学意义(P均<0.05)。术后3例患者出现治疗侧下颌区疼痛,1周内消失,未见其它并发症。结论PRP三叉神经节注射治疗三叉神经PHN是一种有效的新方法。Objective To observe the effect of percutaneous injection of platelet-rich plasma(PRP)into trigeminal ganglion for treatment of patients with trigeminal postherpetic neuralgia(PHN).Methods Twenty-one patients with trigeminal postherpetic neuralgia were collected from March 2019 to October 2020 in the Department of Painology,Weihai Municipal Hospital.0.5 ml PRP with platelet enrichment degree of(5.7±1.1)was injected into trigeminal ganglion and ovale foramen respectively through percutaneous puncture under local anesthesia.NRS was recorded before the treatment and at 1 day,7 days,15 days,30 days and 90 days after the treatment,and painless,mild,moderate and severe pain degree were recorded at the same time points in all patients.The complications were observed after the treatment.Results After the treatment,NRS was significantly decreased[4.0(2.0),3.0(1.5),2.0(2.0),1.0(1.0),0(2.5)]at 1 day,7 days,15 days,30 days and 90 days respectively than that before the treatment 7.0(2.0)(all P<0.05).At 90 days after the treatment,only two patients with moderate pain and no patients with severe pain,which were 6 cases and 15 cases respectively before the treatment(P<0.05).Three patients felt pain in the mandibular region after the treatment and the pain disappeared within 1 week.No other complications were observed.Conclusion Percutaneous platelet-rich plasma injection into trigeminal ganglion is an effective new method for the treatment of trigeminal postherpetic neuralgia.

关 键 词：三叉神经节 富含血小板的血浆 三叉神经 神经痛 带状疱疹后 

分 类 号：R745.11[医药卫生—神经病学与精神病学]