双电极短时程脊髓电刺激治疗带状疱疹后神经痛的应用研究  

A clinical study on the treatment of postherpetic neuralgia with short-term dual electrodes spinal cord stimulation

作　　者：乔保光 吴方方 陈巧艳[1] 朱岩 张雁[1] 何睿林[2] QIAO Bao-guang;WU Fang-fang;CHEN Qiao-yan;ZHU Yan;ZHANG Yan;HE Rui-lin(Department of Pain Medicine,Heze Municipal Hospital,Heze 274031,China;Department of Pain Medicine,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]山东省菏泽市立医院疼痛科,菏泽274031 [2]广西医科大学第二附属医院疼痛科,南宁530007

出　　处：《中国疼痛医学杂志》2025年第3期189-195,共7页Chinese Journal of Pain Medicine

基　　金：菏泽市立医院科技发展计划项目(2022YN01);广西壮族自治区中医药管理局自筹经费科研课题(GZZC2020191)。

摘　　要：目的:探讨双电极短时程脊髓电刺激治疗带状疱疹后神经痛的有效性和安全性。方法:选择2022年3月至2024年2月山东省菏泽市立医院和广西医科大学第二附属医院就诊且病程在3个月内的带状疱疹后神经痛病人80例,择期行短时程脊髓电刺激治疗,采用随机数字表法分为单电极组和双电极组,每组40例。记录两组手术时间、异感覆盖范围、治疗时间、治疗相关的并发症例数(神经损伤、硬膜外血肿、感染、脑脊液漏、电极移位)和术后6个月有效率;比较术前、治疗结束时、术后1、6个月的疼痛数字分级评分法(numerical rating scale,NRS)评分、匹兹堡睡眠质量指数(Pittsburg sleep quality index,PSQI)。结果:两组术后各时间点NRS评分和PSQI评分均小于术前(P<0.05),术后双电极组各时间点NRS评分和PSQI评分均小于单电极组(P<0.05)。双电极组手术总时间长于单电极组(P<0.05),双电极组异感覆盖范围大于单电极组(P<0.05),两组治疗天数和治疗并发症比较差异无统计学意义。双电极组术后6个月有效率大于单电极组(P<0.05)。结论:双电极短时程脊髓电刺激治疗带状疱疹后神经痛明显增加异感覆盖范围,疗效优于单电极短时程脊髓电刺激,可作为短时程脊髓电刺激治疗带状疱疹后神经痛的新方法。Objective:To investigate the efficacy and safety of short-term spinal cord stimulation(stSCS)with dual electrodes in the treatment of postherpetic neuralgia(PHN).Methods:Eighty patients with postherpetic neuralgia who had a course of disease within 3 months from Heze Municipal Hospital and the Second Affiliated Hospital of Guangxi Medical University from March 2022 to February 2024 were selected and treated with short-term spinal cord stimulation.Patients were divided into single electrode group and dual electrode group using random number table method,with 40 case in each group.Information regarding operation time,paraesthesia coverage,treatment time,Number of treatment-related complications(nerve injury,epidural hematoma,infection,cerebrospinal fluid leakage,electrode migration)and 6 months postoperative effective rate were recorded.The numerical rating scale(NRS)score and Pittsburgh sleep quality index(PSQI)were compared before surgery,at the end of treatment,1 and 6 months after surgery.Results:The NRS score and PSQI score at each time point after surgery were lower in both groups than that before surgery(P<0.05).The NRS score and PSQI score at each time point after surgery in dual electrode group were lower than that in single electrode group(P<0.05).The total operation time in dual electrode group was longer than that in single electrode group(P<0.05),and the coverage of paraesthesia in dual electrode group was larger than that in single electrode group(P<0.05).There were no significant differences in treatment days and treatment complications between the two groups.The effective rate 6 months after operation in dual electrode group was higher than that in single electrode group(P<0.05).Conclusion:Dual-electrode short-term spinal cord stimulation for postherpetic neuralgia significantly increases the coverage of paresthesia,and its efficacy is better than that of single-electrode spinal cord stimulation.It can be used as a new method of stSCS for postherpetic neuralgia.

关 键 词：带状疱疹后神经痛 双电极 短时程脊髓电刺激 异感覆盖 神经调控 

分 类 号：R75[医药卫生—皮肤病学与性病学]