比较超声或C型臂引导下神经根脉冲射频治疗老年带状疱疹后神经痛患者的疗效和安全性  

Comparison of the efficacy and safety between ultrasound and C-arm guided nerve root pulsed radiofrequency in elderly patients with postherpetic neuralgia

作　　者：艾比不拉·衣明 玉苏甫·吐尔逊[2] 菲尔东·阿布力孜 张雪[1] 麻鑫 王德全[1] Aibibula Yiming;Yusufu Tuerxun;Feierdong Abulizi;Zhang Xue;Ma Xin;Wang Dequan(Department of Pain Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi City,Xinjiang Uygur Autonomous Region 830001,China;Department of Traditional Chinese Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi City,Xinjiang Uygur Autonomous Region 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院疼痛诊疗中心,乌鲁木齐市830001 [2]新疆维吾尔自治区人民医院中医科,乌鲁木齐市830001

出　　处：《中华疼痛学杂志》2023年第2期268-272,共5页Chinese Journal Of Painology

摘　　要：目的:观察超声与C型臂引导下脉冲射频治疗老年带状疱疹后神经痛患者的疗效及安全性。方法:收集2018年5月5日至2019年8月10日新疆维吾尔自治区人民医院疼痛诊疗中心诊治的老年胸段带状疱疹后神经痛患者90例,年龄>60岁,性别不限,按治疗方法不同分为口服药物组、C型臂射频组和超声射频组,每组30例;口服药物组采用加巴喷丁治疗;C型臂组采用C型臂X线引导下行脉冲射频治疗联合加巴喷丁治疗;超声组采用超声引导下行脉冲射频治疗联合加巴喷丁治疗。比较3组患者治疗前,治疗后1、2、4及12周视觉模拟评分(VAS)、睡眠质量评分(QS),口服加巴喷丁的用量,以及不良反应发生情况。结果:3组患者年龄、性别、病程以及治疗前VAS、QS评分差异无统计学意义( P均>0.05)。与治疗前比较,3组患者治疗后各时点VAS、QS评分均明显降低( P均<0.05);与口服药物组比较,超声射频组及C型臂射频组治疗后各时点VAS、QS评分均较低( P均<0.05),VAS≤3分的比例增高( P均<0.05),口服加巴喷丁的用量较少( P均<0.05),头晕、恶心呕吐发生率较低( P均<0.05);而超声射频组与C型臂射频组比较,各时点疗效与不良反应发生率差异无统计学意义( P均>0.05)。 结论:超声及C型臂引导下脉冲射频治疗对老年带状疱疹后神经痛疗效均确切,超声引导安全性较高。Objective To observe the efficacy and safety of ultrasound guided or C-arm guided pulsed radiofrequency for treatment of postherpetic neuralgia in the elderly.Methods Ninety elderly patients with postherpetic neuralgia were collected from the Department of Pain Medicine,People's Hospital of Xinjiang Uygur Autonomous Region from May 5,2018 to August 10,2019,and divided into oral drugs group,C-arm guided radiofrequency group and ultrasound guided radiofrequency group according to the therapeutic method,with 30 cases in each group.Patients were received gabapentin,C-arm guided pulsed radiofrequency therapy combined with gabapentin,ultrasound-guided pulsed radiofrequency therapy combined with gabapentin in the three groups respectively.Visual analogue scale(VAS),quality of sleep(QS),dosage of gabapentin,and adverse reactions were recorded before the treatment,and 1,2,4,12 weeks after the treatment.Results There were no significant differences in age,gender,course of disease,VAS and QS scores before the treatment among the three groups(all P>0.05).Compared with before the treatment,VAS and QS scores were significantly decreased in the three groups at each follow-up time after the treatment(all P<0.05).Compared with oral drugs group,VAS and QS scores were decreased,the proportion of VAS≤3 was increased,the dosage of oral gabapentin and the incidences of dizziness,nausea and vomiting were low at 1,2,4,12 weeks after the treatment in C-arm guided radiofrequency group and ultrasound guided radiofrequency group(all P<0.05),but no significant difference between the two radiofrequency groups(all P>0.05).Conclusion Ultrasound guided or C-arm guided pulsed radiofrequency treatment is effective and safe for elderly patients with postherpetic neuralgia,with better safety by ultrasound guided radiofrequency.

关 键 词：神经痛 带状疱疹后 老年人 超声检查 多普勒 X线 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]