超声引导下颈神经根阻滞治疗颈部带状疱疹性神经痛的疗效观察  

作　　者：涂祈国 阙彬[1] 何杰[2] 王波[2] 杜忠举[2] 张华[2] 周蓉[1] 

机构地区：[1]杭州市中医院,310007 [2]杭州市第三人民医院,310009

出　　处：《浙江临床医学》2023年第7期1005-1007,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省中医药科技计划项目(2022ZA105);浙江省医药卫生科技计划项目(2021KY905)。

摘　　要：目的探讨超声引导下颈神经根阻滞联合普瑞巴林对颈部带状疱疹性神经痛的疗效。方法选择颈部带状疱疹性神经痛患者60例,随机数字法分为两组,A组(对照组,30例):口服普瑞巴林治疗;B组(阻滞组,30例):口服普瑞巴林联合超声引导下颈神经根阻滞治疗。记录两组患者治疗前(T0)及治疗后第1周(T1)、第2周(T2)、第4周(T3)、第8周(T4)的视觉模拟评分(VAS)、匹兹堡睡眠质量指数(PQSI);普瑞巴林总用量、治疗总有效率以及治疗期间发生的相关不良反应。结果两组VAS和PQSI在T1~4时比T0降低(P<0.05)。B组患者在T1、T3、T4时VAS评分比A组降低(P<0.05);B组患者在T3、T4时PQSI评分比A组降低(P<0.05);B组口服普瑞巴林总量明显低于A组(P<0.05);B组总有效率高于A组(P<0.05),B组头晕、嗜睡发生率少于A组(P<0.05),B组发生2例无严重后果的神经阻滞并发症。结论超声引导下颈神经根阻滞联合普瑞巴林能改善带状疱疹性神经痛及睡眠质量,减少普瑞巴林用药量及不良反应。Objective To study the effect of ultrasound-guided cervical nerve root block combined with pregabalin in the treatment of the cervical herpetic neuralgia.Methods Sixty patients with herpetic neuralgia in neck were randomly divided into two groups:group A was treated with oral pregabalin(n=30),group B was treated with ultrasound-guided cervical nerve root block combined with oral pregabalin(n=30).Visual analog scale(VAS)and Pittsburgh Sleep Quality Index(PQSI)were recorded before the treatment(T0)and at the 1st week(T1),the 2nd week(T2),the 4th week(T3)and the 8th week(T4)after the treatment in 2 groups.Total dosage of pregabalin,total response rate and associated adverse reactions during the treatment were recorded.Results Comparison within groups:the VAS and PQSI of both groups at T1-4 were significantly lower than T0(P<0.05).Compared with the group A,the VAS scores of the group B were significantly lower at T1,T3 and T4(P<0.05).Compared with the group A,the PQSI of the group B was significantly lower at T3 and T4(P<0.05).The total amount of oral pregabalin in group B was significantly lower than that in group A(P<0.05).The total effective rate of group B was higher than that of group A(P<0.05).The incidence of dizziness and drowsiness in the group B was less than that in the group A.There were 2 cases of nerve block complications without serious consequences in the group B.Conclusion Ultrasound-guided CNRB combined with pregabalin can better improve herpetic neuralgia and sleep quality,reduce the dosage of pregabalin and adverse reactions.

关 键 词：带状疱疹 神经痛 超声引导 神经传导阻滞 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]