摘要
目的:观察CT引导下四肢带状疱疹后遗神经痛(PHN)持续硬膜外输注镇痛结合交感神经射频热凝治疗的临床结果。方法:32例四肢带状疱疹后遗神经痛患者随机分为对照组(A组,采用硬膜外置管持续输注镇痛治疗,n=17)和联合治疗组(B组,采用持续硬膜外置管镇痛3—4周后行交感神经射频热凝治疗3次,n=15),比较治疗前后7d、1个月、6个月、1年的视觉模拟评分(VAS)、疼痛缓解率、生存质量评分(QOL)、麻木评分、肌力下降发生率。结果:治疗后两组患者的VAS评分均较治疗前明显降低(P<0.05);治疗后6个月、1年,B组的VAS、QOL、疼痛缓解率均优于A组(P<0.05),同时A、B两组的麻木发生率和麻木评分均无显著性差异(P>0.05),治疗后两组均无肌力下降发生。结论:四肢带状疱疹后遗神经痛持续硬膜外镇痛结合交感神经射频毁损治疗可有效缓解疼痛,长期疗效高于单纯持续硬膜外镇痛,同时并不增加麻木及肌力下降的发生率。
Objective： To evaluate the efficacy of continuous epidural infusion combined with sympathetic nerve radiofrequency thermocoagulation guided by CT scanning in the treatment of postherpetic neuralgia（PHN） in the limbs. Method： A total of 33 patients with PHN in the limbs were randomly assigned to control group （A group, patients were given continuous epidural infusion, n=17） and combined group （B group, patients were given continuous epidural infusion for 3 to 4 weeks, then sympathetic nerve radiofrequency thermocoagulation of 85℃, n=18）. Patients were asked to rate their pain with visual analogue scale （VAS） at 7 days,1 month, 6 .months and 1 year after the treatment. Pain relief rate, quality of life（QOL）score, numbness score, and the rate of muscle strength decrease were also recorded. Result： After treatment VAS scores decreased in both groups（P〈0.05）. At 6 months and 1 year after treatment compared with A group, B group had better therapeutic effect with lower VAS, higher QOL score and pain relief rate （P〈0.05 ）. There were no significant difference in rate of numbness and numbness score. Muscle strength decrease had not been observed in both groups. Conclusion： The combination of continuous epidural infusion and sympathetic nerve radiofrequency thermocoagulation was effective in treatment of PHN, it＇s long-term effect was superior to continuous epidural infusion alone.The risk of numbness and muscle strength decrease didn＇t increase after the combined treatment.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2012年第7期611-615,共5页
Chinese Journal of Rehabilitation Medicine
关键词
带状疱疹后遗神经痛
持续硬膜外输注
交感神经
射频热凝
postherpetic neuralgia
continuous epidural infusion
sympathetic nerve
radiofrequency thermocoagulation
