奇神经节射频热凝和脉冲射频治疗原发性会阴痛的效果评价  

Efficacy evaluation of radiofrequency thermocoagulation and pulse radiofrequency for the ganglion impar in treating primary perineal pain

作　　者：王辉[1] 张丹丹[2] 聂会勇[1] 王欢[1] 卜岗 WANG Hui;ZHANG Dandan;NIE Huiyong;WANG Huan;BU Gang(Department of Pain Management,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Geriatric Cardiology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061)

机构地区：[1]西安交通大学第一附属医院疼痛科,陕西西安710061 [2]西安交通大学第一附属医院老年内一科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第4期595-600,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划项目(No.2020SF-131)。

摘　　要：目的综合比较奇神经节射频热凝和脉冲射频治疗原发性会阴痛的治疗效果。方法分析2020年1月至2022年3月行奇神经节射频热凝(A组)和脉冲射频(B组)治疗的79例原发性会阴痛患者,评价术前、术后24 h、1周、1个月、3个月和6个月的疼痛程度(VAS)、优良率、睡眠质量(PSQI)、术后口服药物、并发症及复发情况,比较两组间的差异。结果A组VAS评分在术后随访各节段呈现逐渐下降趋势,B组VAS评分在术后24 h下降之后又逐步增加。A组VAS评分在术后1周开始低于B组(P<0.05),且随着时间的延长组间差异进一步增加(P<0.001)。在随访6个月后,A组优良率(86%)明显高于B组(22%)。除了术后会阴区皮肤麻木外,A组在改善睡眠、术后口服用药(普瑞巴林和阿片类)和病情复发方面均优于B组(P<0.05)。结论奇神经节射频热凝能够通过减轻疼痛、提高优良率、改善睡眠、降低复发及减少用药来提高生活质量,效果优于脉冲射频。Objective To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain.Methods We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation(group A)and pulsed radiofrequency(group B)in the ganglion impar from January 2020 to March 2022.VAS,excellent and good rates,sleep quality,postoperative medication usage,complications,and recurrence were evaluated before and 24 h,1 W,1 M,3 M and 6 M after operation.The differences between the two groups were compared.Results The VAS score of group A gradually decreased at each level after operation,and the VAS score of group B gradually increased after 24 hours of operation.The differences between the two groups began to appear 1 week after operation,and the differences further increased with the extension of time(P<0.001).In six months after follow-up,the excellent and good rates of group A(86%)was significantly higher than that of group B(22%).In addition to postoperative perineal skin numbness,group A was superior to group B in improving sleep,postoperative oral medication(pregabalin and opioids),and disease recurrence(P<0.05).Conclusion Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain,improving the excellent and good rates,improving sleep,and reducing recurrence a medication.The effect is better than that of pulsed radiofrequency.

关 键 词：奇神经节 射频热凝 脉冲射频 会阴痛 神经病理性疼痛 

分 类 号：R745.7[医药卫生—神经病学与精神病学]