超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析

doi:10.7517/issn.1674-0475.181001

影像科学与光化学 ›› 2019, Vol. 37 ›› Issue (2): 163-168.DOI: 10.7517/issn.1674-0475.181001

超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析

张艳茹¹, 封卫征¹, 邵徽英², 刘首芳¹, 段昌玲¹, 赵佳敏¹

1. 上海市嘉定区南翔医院, 上海 201802;
2. 复旦大学附属儿科医院, 上海 201102

收稿日期:2018-09-30 修回日期:2018-11-28 出版日期:2019-03-15 发布日期:2019-03-15
通讯作者: 封卫征
基金资助:
上海市嘉定区卫计委课题（2015-QN-02）资助

Efficacy and Feasibility Analysis of Ultrasound-guided Paravertebral Nerve Block for the Treatment of Post-herpetic Neuralgia

ZHANG Yanru¹, FENG Weizheng¹, SHAO Huiying², LIU Shoufang¹, DUAN Changling¹, ZHAO Jiamin¹

1. Jiading Nanxiang Hospital, Shanghai 201802, P. R. China;
2. Children's Hospital of Fudan University, Shanghai 201102, P. R. China

Received:2018-09-30 Revised:2018-11-28 Online:2019-03-15 Published:2019-03-15

摘要/Abstract

摘要： 本文对超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛（post-herpetic neuralgia，PHN）的疗效及可行性进行了分析。研究对象为2015年12月~2017年12月于我院就诊的94例PHN患者，按就诊顺序随机均分为两组，对照组给予普瑞巴林常规治疗，观察组在此基础上联合超声引导椎旁神经阻滞治疗，连续治疗4周。本文比较了治疗前、治疗1周、2周、4周后的匹兹堡睡眠质量指数（PSQI）评分、疼痛视觉模拟（VAS）评分，并评价了治疗后的综合疗效，记录了治疗期间发生不良反应情况。结果显示，较治疗前，治疗1周、2周、4周后两组VAS评分均逐渐降低，且观察组治疗后各时间点的VAS评分显著低于对照组，差异具有统计学意义（P<0.05）；较治疗前，两组治疗1周、2周、4周后PSQI评分均逐渐降低，且观察组治疗后各时间点的PSQI评分显著低于对照组，差异具有统计学意义（P<0.05）；观察组治疗总有效率为89.36%，对照组为78.72%，观察组显著高于对照组，差异具有统计学意义（P<0.05）；两组治疗期间各项不良反应发生率差异无统计学意义（P>0.05）。本文证实了超声引导椎旁神经阻滞治疗PHN能显著改善患者神经疼痛症状，提升睡眠质量，同时具有安全性保障。

关键词: 超声引导椎旁神经阻滞, 普瑞巴林, 带状疱疹后遗神经痛

Abstract: To analysis the efficacy and feasibility of ultrasound-guided paravertebral nerve block for the treatment of post-herpetic neuralgia, ninety-four patients with PHN admitted to our hospital from December 2015 to December 2017 were selected as the study subjects. They were randomly divided into two groups according to the order of treatment. The control group received routine treatment with pregabalin, and the observation group combined routine treatment with ultrasound-guided paravertebral nerve block therapy for 4 weeks. Pittsburgh sleep quality index (PSQI) scores and pain visual analogue (VAS) scores before treatment, 1 week, 2 weeks, and 4 weeks of treatment were compared. The combined efficacy after treatment was evaluated, and the adverse reactions during treatment were recorded. The results showed that compared with pre-treatment, the VAS scores of the two groups were gradually decreased at 1 week, 2 weeks, and 4 weeks of treatment, and the observation group was significantly lower than the control group at each time point after treatment, the difference was statistically significant (P<0.05). The PSQI scores of the two groups were gradually decreased at 1 week, 2 weeks, and 4 weeks of treatment, and the observation group was significantly lower than the control group at each time point after treatment, the difference was statistically significant (P<0.05). The total effective rate was 89.36% in the observation group and 78.72% in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Ultrasound-guided paravertebral nerve block for PHN can significantly reduce neuropathic pain in patients, improve sleep quality, and has security guarantee.

Key words: ultrasound-guided paravertebral nerve block, pregabalin, post-herpetic neuralgia

张艳茹, 封卫征, 邵徽英, 刘首芳, 段昌玲, 赵佳敏. 超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析[J]. 影像科学与光化学, 2019, 37(2): 163-168.

ZHANG Yanru, FENG Weizheng, SHAO Huiying, LIU Shoufang, DUAN Changling, ZHAO Jiamin. Efficacy and Feasibility Analysis of Ultrasound-guided Paravertebral Nerve Block for the Treatment of Post-herpetic Neuralgia[J]. Imaging Science and Photochemistry, 2019, 37(2): 163-168.

参考文献

[1] 杨梅, 章绍清, 吴艳霞,甘心红,陶绍平,周青,张五七,施炜,金雯. 带状疱疹后遗神经痛发病相关因素及干预方法分析[J]. 现代预防医学, 2013, 40(1):153-155. Yang M, Zhang S Q, Wu Y X, Gan X H, Tao S P, Zhou Q, Zhang W Q, Shi W, Jin W. Analysis of related factors and intervention methods for postherpetic neuralgia[J]. Modern Preventive Medicine, 2013, 40(1):153-155.
[2] 陈希颖,季必华. 带状疱疹后遗神经痛的治疗进展[J]. 国际皮肤性病学杂志, 2016, 42(4):209-211. Chen X Y, Ji B H. Progress in the treatment of postherpetic neuralgia[J]. International Journal of Dermatology, 2016, 42(4):209-211.
[3] Alicino C, Trucchi C, Paganino C, Barberis I, Boccalini S, Martinelli D, Pellizzari B, Bechini A, Orsi A, Bonanni P, Prato R, Iannazzo S, Icardi G. Incidence of herpes zoster and post-herpetic neuralgia in Italy:results from a 3-years population-based study[J]. Human Vaccines & Immunotherapeutics, 2017, 13(2):399-404.
[4] 王家双, 于生元. 带状疱疹后神经痛临床治疗指引[C]. 中华医学会疼痛学分会年会暨CASP成立二十周年论文集,2009. Wang J S, Yu S Y. Guidelines for clinical treatment of postherpetic neuralgia[C]. The 20th Anniversary of the Chinese Medical Association Pain Society and the establishment of CASP, 2009.
[5] Mizukami A, Sato K, Adachi K, Matthews S, Holl K, Matsuki T, Kaise T, Curran D. Impact of herpes zoster and post-herpetic neuralgia on health-related quality of life in Japanese adults aged 60 years or older:results from a prospective, observational cohort study[J]. Clinical Drug Investigation, 2018, 38(1):29-37.
[6] Ding X D, Zhong J, Liu Y P,Chen H X. Botulinum as a toxin for treating post-herpetic neuralgia[J]. Iranian Journal of Public Health, 2017, 46(5):608-611.
[7] 王斌, 瞿伟, 胡银娥. 无环鸟苷对带状疱疹后遗神经痛的防治作用[J]. 广东医学, 2016, 37(s1):210-211. Wang B, Qu W, Hu Y E. Prevention and treatment of acyclovir on postherpetic neuralgia[J]. Guangdong Medical Journal, 2016, 37(s1):210-211.
[8] Jakobs M, Unterberg A, Treede R D, Schuh-Hofer S, Ahmadi R. Subcutaneous trigeminal nerve field stimulation for refractory trigeminal pain:a cohort analysis[J]. Acta Neurochirurgica, 2016, 158(9):1-8.
[9] 孙龙.干扰素联合普瑞巴林治疗带状疱疹后遗神经痛效果观察[J]. 山东医药, 2017, 57(26):76-77. Sun L. Effect of interferon combined with pregabalin on post-herpetic neuralgia[J]. Shandong Medicine, 2017, 57(26):76-77.
[10] 丁伟民, 吴玮, 郑旺福, 丁雷鸣, 吴丹, 应锦河, 许丽华. 带状疱疹后遗神经痛患者继发感染病原菌特点及相关影响因素分析[J]. 中华医院感染学杂志, 2017, 27(22):5137-5140. Ding W M, Wu W, Zheng W F, Ding L M, Wu D, Ying J H, Xu L H. Characteristics of secondary infection pathogens in patients with postherpetic neuralgia and related influencing factors[J]. Chinese Journal of Hospital Infection, 2017, 27(22):5137-5140.
[11] 周艳. 带状疱疹后神经痛患者血清CGRP水平与疼痛、抑郁的关系[J]. 山东医药, 2016, 56(46):88-90. Zhou Y. Relationship between serum CGRP levels and pain and depression in patients with postherpetic neuralgia[J]. Shandong Medicine, 2016, 56(46):88-90.
[12] Lopez-Belmonte J L, Cisterna R, Miguel A G D, Guilmet C, Bianic F, Uhart M. The use of Zostavax in Spain:the economic case for vaccination of individuals aged 50 years and older[J]. Journal of Medical Economics, 2016, 19(6):576-586.
[13] 夏菊荣, 杜忠举. 普瑞巴林联合超声引导下椎旁神经阻滞对带状疱疹后遗神经痛治疗效果的临床研究[J]. 中国医师杂志, 2017, 19(10):1570-1572. Xia J R,Du Z J,Clinical study on the therapeutic effect of pregabalin combined with ultrasound-guided paravertebral nerve block on postherpetic neuralgia[J]. Chinese Journal of Physicians, 2017, 19(10):1570-1572.
[14] 卫琰, 陈弘, 张昕, 李立志, 杜冬萍. 超声引导下胸椎旁神经阻滞对老年带状疱疹后神经痛的疗效分析[J]. 中国疼痛医学杂志, 2016, 22(7):510-513. Wei Y, Chen H, Zhang X, Li L Z, Du D P. Ultrasound-guided thoracic paravertebral nerve block for the treatment of post-herpetic neuralgia in the elderly[J]. Chinese Journal of Pain Medicine, 2016, 22(7):510-513.
[15] Taketa Y, Fujitani T, Irisawa Y, Sudo S,Takaishi K.Ultrasound-guided thoracic paravertebral block by the paralaminar in-plane approach using a microconvex array transducer:methodological utility based on anatomical structures[J]. Journal of Anesthesia, 2017, 31(2):271-277.
[16] Kasuya Y, Moriwaki S, Inano C, Fukada T, Komatsu R, Ozaki M. Feasibility of the head-mounted display for ultrasound-guided nerve blocks:a pilot simulator study[J]. Journal of Anesthesia, 2017, 31(5):1-3.
[17] Harrison T K, Kim T E, Kou A, Shum C, Mariano E R, Howard S K. Feasibility of eye-tracking technology to quantify expertise in ultrasound-guided regional anesthesia[J]. Journal of Anesthesia, 2016, 30(3):530-533.

超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析

Efficacy and Feasibility Analysis of Ultrasound-guided Paravertebral Nerve Block for the Treatment of Post-herpetic Neuralgia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价