超声辅助肋间神经阻滞治疗带状疱疹后神经痛的疗效及对患者疼痛应激反应影响分析  

Analysis of the efficacy of ultrasound-assisted intercostal nerve block in the treatment of postherpetic neuralgia and its effect on patients pain stress response

作　　者：陈香郡[1] 陈红 林海凤[1] 徐江宁 许福星 CHEN Xiangjun;CHEN Hong;LIN Haifeng;XU Jiangning;XU Fuxing(Chongqing Medical and Pharmaceutical College,Chongqing 401331;The First Affilliated Hospital of Chongqing Medical and Pharmaceutical College,Chongqing 401331;PLA 94995 Unit Hospital,Rugao 226500,China)

机构地区：[1]重庆医药高等专科学校,重庆401331 [2]重庆医药高等专科学校附属第一医院,重庆401331 [3]中国人民解放军94995部队医院,江苏如皋226500

出　　处：《麻醉安全与质控》2024年第4期187-190,共4页Perioperative Safety and Quality Assurance

基　　金：重庆医药高等专科学校科研项目(YGZ2019105、YGZ20230401);重庆市沙坪坝区科卫联合医学科研项目(2023SQKWLH036);重庆市教育委员会市教委科学技术研究计划项目(KJQN202102807)。

摘　　要：目的观察超声辅助肋间神经阻滞治疗带状疱疹后神经痛(PHN)的疗效及疼痛应激反应。方法选取2021-10/2023-12期间某院收治的PHN患者88例为研究对象,采用随机数字表法分为对照组(n=44)和观察组(n=44),对照组实施盲探肋间神经阻滞治疗,观察组采用超声辅助肋间神经阻滞治疗,记录2组患者治疗8周总有效率;用视觉模拟评分法(VAS)记录2组患者治疗前,治疗后1周、2周、4周、8周的疼痛程度;记录2组患者治疗前、治疗8周后血清免疫球蛋白水平,包括免疫球蛋白G(IgG)、免疫球蛋白M(IgM)和血清高迁移率族蛋白(HMGB1)、CXC趋化因子配体10(CXCL-10);用生活质量量表记录2组患者治疗8周后的生活质量水平。结果治疗后8周,观察组总有效率(93.2%)高于对照组(77.3%),差异有统计学意义(P<0.05);治疗1周、2周、4周、8周观察组VAS评分低于对照组,差异有统计学意义(P<0.05);治疗后8周,观察组的IgG水平高于对照组,观察组的HMGB1、CXCL-10水平低于对照组,观察组的生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论PHN患者接受超声辅助肋间神经阻滞治疗,可以有效缓解神经疼痛感,并提升血清免疫球蛋白水平和降低血清HMGB1、CXCL-10水平,改善患者的预后情况。Objective To explore the therapeutic effect and pain stress response of ultrasound-assisted intercostal nerve block in the treatment of postherpetic neuralgia(PHN).Methods Altogether 88 patients with postherpetic neuralgia admitted to our hospital from October 2021 to December 2023 were selected and randomly divided into the control group(n=44)and the observation group(n=44)according to random number table method.The control group received blind intercostal nerve block treatment,while the observation group received ultrasound assisted intercostal nerve block treatment.The total clinical effective rate of the two groups of patients after 8 weeks of treatment was recorded.The Visual Analog Scale(VAS)was used to record the pain levels of two groups of patients before treatment and after 1,2,4,and 8 weeks of treatment.The serum immunoglobulin levels of two groups of patients before treatment and after 8 weeks of treatment,including immunoglobulin G(IgG),immunoglobulin M(IgM),and serum high mobility box1(HMGB1)and CXC chemokine ligand 10(CXCL-10)were recorded.Meanwhile the quality of life levels of two groups of patients after 8 weeks of treatment were recorded using a quality of life scale.Results After 8 weeks of treatment,the total effective rate of the observation group(93.2%)was higher than that of the control group(77.3%),and the difference was statistically significant(P<0.05).The VAS scores of the observation group were lower than those of the control group after 1 week,2 weeks,4 weeks,and 8 weeks of treatment,and the difference was statistically significant(P<0.05).After 8 weeks of treatment,the level of IgG in the observation group was higher than that in the control group,while the levels of HMGB1 and CXCL-10 in the study group were lower than those in the control group,with statistical significance(P<0.05);the quality of life score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound assisted intercostal nerve bloc

关 键 词：超声辅助肋间神经阻滞 带状疱疹后神经痛 VAS评分 免疫球蛋白G水平 血清高迁移率族蛋白水平 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]