摘要
目的评价选择性神经根脉冲射频术联合医用三氧注射治疗胸肋部带状疱疹后神经痛患者的临床疗效。方法胸肋部带状疱疹后神经痛患者40例，年龄50—74岁，体重45—90kg，随机分为两组：单纯脉冲射频组（PRF组，n=20）和脉冲射频联合医用三氧注射组（PRF—O3组，n=20）。PRF组依据其带状疱疹及疼痛区域神经节段分布范围行DSA引导下选择性神经根脉冲射频治疗；PRF—O3组给予相同的脉冲射频治疗，治疗毕注射40％浓度的医用三氧5ml。治疗后如患者VAS评分〉3，给予口服加巴喷丁胶囊300mg，每次给药间隔8h。于治疗前1d，治疗后1、3、30、90d时记录患者VAS评分，抑郁自评量表（SDS）评分及焦虑自评量表（SAS）评分；记录患者加巴喷丁胶囊使用情况并记录不良反应。结果与治疗前比较，两组患者VAS评分、SDS及SAS评分均明显降低（P〈0．05）；相同时点与PRF组比较，PRF—O3组VAS评分、SDS及SAS评分降低更明显（P〈0．05），加巴喷丁使用剂量明显减少（P〈0．05）。所有患者均未发现头晕、心慌、胸闷等并发症，PRF—O3组有3例患者注射医用三氧时出现注射部位胀痛，均可忍受，持续约5—10min自行消失。结论选择性神经根脉冲射频术联合医用三氧注射治疗可安全、有效地缓解患者胸肋部带状疱疹后神经痛，减轻患者抑郁及焦虑状态，减少加巴喷丁用量。
Objective To investigate the efficacy of pulse radiofrequency combined with medical ozone injection in selective nerve root on patients with chest-costal postherpetic neuralgia. Methods Forty patients with postherpetic neuralgia, aged 50-74 years, weighing 45-90 kg, were randomly divided into two groups： pulse radiofrequency group （PRF group） and pulse radiofrequency combined with medical ozone injection group （PRF-O3 group）, 20 cases in each group . The patients in PRF group received selective nerve root pulse radiofrequency therapy guided by DSA, in PRF-O3 group received the same selective nerve root pulse radiofrequency therapy, and 40% medical ozone 5 ml injected after that . After the treatment, oral gabapentin capsule 300 mg was given if VAS in patients was more than 3, each time interval of 8 h. The VAS, self-rating depression scale （SDS） and self-rating anxiety scale （SAS） were recoreded at 1 d before the treatment and 1, 3, 30, 90 d after the treatment respectively. Dose of gabapentin capsules and side effects were observed in both groups. Results Compared with pretreatment, the VAS, SDS and SAS of the two groups were significantly decreased, with even more significantly lower in PRF-O3 group at 1, 3, 30, 90 d after the treatment （P〈0.05）. Dose of gabapentin capsules was significantly lower in PRF-O3 group than that in PRF group （P〈 0.05）. Dizziness, palpitation, chest tightness and other complications were not found in all patients. Three patients in PRF-O3 group felt pain during ozone injected and disappeared in 5-10 min later. Conclusion Pulse radiofrequency combined with medical ozone injection in selective nerve root can safely and effectively relieve chest-costal postherpetic neuralgia, ease depression and anxiety, and reduce the dose of gabapentin capsules.
出处
《实用疼痛学杂志》
2017年第6期415-420,共6页
Pain Clinic Journal
关键词
神经痛
带状疱疹后
医用三氧
脉冲射频
脊神经根
Neuralgia, postherpetic
Medical ozone
Pulse radiofrequency
Spinal nerve roots
