摘要
目的探讨连续射频毁损联合阿霉素对顽固性神经痛的干预作用。方法根据前瞻性研究和自身对照研究原则,随机选取我院近3年诊治的顽固性神经痛患者85例,患者均首先接受2个疗程的连续射频毁损治疗,评估疗效,随后联合阿霉素继续治疗2个疗程,观察治疗前(T0)、治疗后第一疗程(T1)、第二疗程(T2)、第三疗程(T3)和第四疗程(T4)结束时患者的疼痛改善情况,采用统计视觉模拟评分(VAS评分)和匹兹堡睡眠质量指数量表(PSQI)评估患者疼痛恢复情况,并采用病人总体改变印象量表(PGIC)评估临床治疗效果,观察患者的并发症情况。结果经2个疗程的连续射频毁损后,患者VAS评分较治疗前降低(配对t检验值6.221,P=0.001),而T4时VAS为(4.25±1.56),较T2时(6.66±1.25)明显下降,下降更为明显,下降幅度高达36.19%,组间比较存在显著性差异(t=9.21,P=0.001)。患者平均睡眠分数在T4时改善最为明显,为(2.66±0.51)分,与T2(5.01±1.05)分,减轻幅度为46.91%,经配对t检验,T=8.124,P=0.001。PGIC评估显示,T4时患者好转率达78.82%,明显高于T2时(χ~2值=4.154,P=0.021)。共9例出现并发症,其中嗜睡3例,恶心3例,多汗2例,眩晕1例,总发生率10.59%。结论在连续射频毁损的基础上加用阿霉素治疗顽固性神经痛可获得更加可靠的疗效,改善睡眠且不增加并发症发生率。
Objective To investigate the interventional effect of continuous radiofrequency ablation combined with adriamycin on intractable neuralgia.Methods According to the prospective study and the Self Control study principle,85 patients with intractable neuralgia were randomly selected in our hospital for nearly 3 years,and the patients were treated with 2 consecutive radiofrequency ablation therapy,and then combined with Adriamycin to continue treatment for 2 courses.Before treatment（T0）,first course of treatment（T1）,Second course（T2）,the third course（T3）and the fourth course（T4）,the patient＇s pain was improved using statistical visual analogue scoring（VAS score）and the Pittsburg Sleep Quality Reference scale（PSQI）were alsoused to assess the patient＇s pain recovery and used the total change impression scale（pgic）to evaluate the effect of clinical treatment and observed the complications of patients.Results After 2 sessions of continuous radiofrequency ablation,the VAS score was lower than before treatment（T= 6.221,P=0.001）,while the T4 vas（4.25±1.56）significantly decreased compared to the T2（6.66±1.25）,the decrease was more pronounced and the decrease was as high as 36.19%,there are significant differences between groups（T=9.21,P=0.001）.The average sleep score of the patients was most obvious in the T4（2.66±0.51）,and T2（5.01±1.05）,the reduction amplitude was 46.91%（t=8.124,P=0.001）.Pgic evaluation showed that the improvement rate of T4 was 78.82%,significantly higher than T2（χ^2 value =4.154,P=0.021）.A total of 9 cases showed complications,including drowsiness in 3 cases,nausea in 3 cases,hyperhidrosis in 2 cases,vertigo in 1 cases,and total incidence of 10.59%.Conclusion The treatment of intractable neuralgia by adding adriamycin on the basis of continuous radiofrequency ablation can obtain more reliable curative effect and improve sleep without increasing the incidence of complication.
作者
张振武
王哲银
凌地洋
韩健
吴呈祥
朱春辉
黎嘉雅
曾荣
Zhang Zhenwu;Wang Zheyin;Ling Diyang(Pain Manage ment , Shenzhen People＇s Hospital, 518020)
出处
《立体定向和功能性神经外科杂志》
2018年第1期5-8,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
连续射频毁损
阿霉素
顽固性神经痛
Continuous radiofrequency ablation
Adriamycin
Intractable neuralgia
