摘要
目的比较低温等离子射频消融术与射频热凝术治疗带状疱疹后神经痛的临床疗效。方法选取2017年10月-2021年10月秦皇岛市第一医院疼痛科收治的231例带状疱疹后神经痛患者,根据治疗方法不同分为药物组(45例)、热凝组(101例)与消融组(85例),其中药物组患者采用加巴喷丁胶囊+甲钴胺片治疗,热凝组采用射频热凝术治疗,消融组采用低温等离子射频消融术治疗。采用视觉模拟评分(Visual analogue scale,VAS)与六维度生活质量简式量表(Short Form-6 Dimensions quality-of-life scale,SF-6D)评分评估各组患者治疗前、治疗1周后、1月后、3月后、6月后的疼痛程度及生活质量,同时记录患者的治疗满意度与术后并发症。采用Logistic回归模型分析影响术后麻木发生的独立危险因素。结果与治疗前比较,三组患者治疗后VAS和SF-6D评分降低,差异有统计学意义(P<0.05)。与药物组治疗1个月、3个月、6个月后比较,热凝组和消融组VAS和SF-6D评分降低,差异有统计学意义(P<0.05)。与热凝组治疗3个月、6个月后比较,消融组VAS和SF-6D评分降低,差异有统计学意义(P<0.05)。与药物组治疗6个月后比较,热凝组和消融组治疗满意率较高,差异有统计学意义(P<0.05)。热凝组术后麻木25例(24.8%)、头晕12例(11.9%)、恶心呕吐7例(6.9%)、感觉减退或肌无力5例(4.9%),而消融组分别3例(3.5%)、8例(9.4%)、7(8.2%)、2例(2.4%)。Logistic回归分析结果显示,低温等离子射频消融术是术后麻木发生的保护因素(OR=0.111,95%CI:0.031-0.404,P<0.05)。结论低温等离子射频消融术治疗带状疱疹后神经痛疗效明确,能够更好地缓解患者疼痛、改善生活质量,患者满意度高,可有效降低术后麻木发生的风险。
Objective To compare the clinical efficacy of low temperature plasma radiofrequency ablation and radiofrequency thermocoagulation intreatment of postherpetic neuralgia.Methods 231 patients with post herpetic neuralgia admitted to the Pain Department of the hospital from October 2017 to October 2021 were selected and divided into drug group(45 cases),thermal coagulation group(101 cases)and ablation group(85 cases)according to the different treatment methods.The patients in the drug group were treated with gabapentin capsule+mecobalamin tablets;thepatients in the thermocoagulation group were treated with radiofrequency thermocoagulation;the patients in the ablation group were treated with low temperature plasma radiofrequency ablation.Visual analog scale(VAS)and Short Form-6 Dimensions quality of life scale(SF-6D)were used to evaluate the pain level and quality of life of thepatients in each group before the treatment,1 week after the treatment,1 month after the treatment,3 months after the treatment,and 6 months after the treatment.At the same time,patients'satisfaction with treatment and postoperative complications were recorded.Logistic regression model was used to analyze the independent risk factors of postoperative numbness.Results Compared with before the treatment,the VAS and SF-6D scores of the three groups were decreased after the treatmentwith a statistically significant difference(P<0.05).Compared with the drug group after 1 month,3 months and 6 months of the treatment,the VAS and SF-6D scores in the thermocoagulation group and the ablation group wasdecreased significantly(P<0.05).Compared with the thermocoagulation group after 3 months and 6 months of thetreatment,the VAS and SF-6D scores in the ablation group wasdecreased significantly(P<0.05).Compared with the drug group after 6 months of the treatment,the treatment satisfaction rate of the thermocoagulation group and the ablation group was higher,the difference was statistically significant(P<0.05).In the thermocoagulation group,25 cases were numb(2
作者
徐幼苗
杨旭
刘悦
李丽梅
刘婷婷
王维彬
张志利
XU Youmiao;YANG Xu;LIU Yue;LI Limei;LIU Tingting;WANG Weibing;ZHANG Zhili(Department of Pain,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)
出处
《新疆医科大学学报》
CAS
2022年第11期1325-1329,共5页
Journal of Xinjiang Medical University
基金
河北省卫生和计划生育委员会科研基金(20191379)。
关键词
带状疱疹后神经痛
低温等离子射频消融术
射频热凝术
麻木
postherpeticneuralgia
low temperature plasma radiofrequency ablation
radiofrequency thermocoagulation
numbness
