前锯肌平面阻滞对老年胸背部带状疱疹后神经痛患者镇痛作用的研究  

Study on the analgesic effect of serratus anterior plane block on elderly patients with chest and back postherpetic neuralgia

作　　者：高献忠[1] 华敏[1] 岳侃 管华[1] 徐晨婕[1] GAO Xianzhong;HUA Min;YUE Kan;GUAN Hua;XU Chenjie(Department of Anesthesia and Pain,Nanjing First Hospital,Nanjing Medical University/Nanjing First Hospital,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院麻醉疼痛科,江苏南京210000

出　　处：《现代医药卫生》2022年第22期3792-3796,共5页Journal of Modern Medicine & Health

基　　金：南京市卫生科技发展专项资金项目计划之医学重点科技发展项目(ZKX18033)。

摘　　要：目的观察前锯肌平面阻滞对老年胸背部带状疱疹后神经痛患者的镇痛治疗效果。方法选择2016年5月至2020年12月南京市第一医院疼痛科诊疗的老年胸背部带状疱疹后神经痛患者76例作为研究对象,将其随机分为口服药物对照组(A组)和超声引导下前锯肌平面阻滞组(B组),每组38例。A组患者以口服加巴喷丁胶囊进行镇痛治疗;B组患者采用超声引导下前锯肌平面阻滞联合口服加巴喷丁胶囊进行镇痛治疗。对比分析两组患者治疗前、治疗后第1、2、4、6、8周的视觉模拟评分法(VAS)评分,治疗前后睡眠质量量表(QS),治疗总有效率及不良反应发生情况。结果B组治疗后1、2、4、6、8周的VAS评分均明显低于A组,差异有统计学意义(P<0.05);治疗后B组QS评分明显低于A组,差异有统计学意义(P<0.05);B组治疗总有效率明显优于A组,差异有统计学意义(P<0.05),而不良反应发生情况差异无统计学意义(P>0.05)。结论前锯肌平面阻滞可有效缓解老年胸背部带状疱疹后神经痛患者的疼痛并改善其睡眠质量。Objective To observe the analgesic effect of serratus anterior plane block on elderly patients with chest and back postherpetic neuralgia.Methods A total of 76 elderly patients with chest and back postherpetic neuralgia who were treated in the pain department of Nanjing First Hospital were randomly divided into oral drug control group(group A)and ultrasound-guided serratus anterior plane block group(group B),with 38 cases in each group.The patients in the group A were treated with oral gabapentin for analgesia,while the group B patients were treated with ultrasound-guided serratus anterior plane block combined with oral gabapentin for analgesia.Visual analog scale(VAS)score before and after treatment at 1,2,4,6 and 8 weeks,sleep quality(QS)score before and after treatment,total effective rate,and occurrence of adverse reactions of the two groups were observed and compared.Results The VAS scores of the group B were significantly lower than those of the group A at 1,2,4,6 and 8 weeks after the treatment(P<0.05),and the QS scores of the group B were significantly lower than those of the group A(P<0.05).The overall effective rate of the group B was significantly higher than that of the group A(P<0.05).There was no significant difference in adverse reactions(P>0.05).Conclusion Serratus anterior plane block can effectively relieve the pain of elderly patients with chest and back postherpetic neuralgia and improve their sleep quality.

关 键 词：前锯肌平面阻滞 带状疱疹后神经痛 加巴喷丁 

分 类 号：R459.9[医药卫生—治疗学] R459.2[医药卫生—临床医学]