首页|脉冲射频治疗激惹型与混合型带状疱疹后神经痛的疗效观察

脉冲射频治疗激惹型与混合型带状疱疹后神经痛的疗效观察

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目的:探讨脉冲射频治疗激惹型与混合型带状疱疹后神经痛的疗效.方法:纳入2020年1月至2023年3月就诊于西南医科大学附属医院疼痛科的带状疱疹后神经痛病人 190 例为研究对象,根据纳入和排除标准最终纳入90例,基于倾向性评分匹配分为混合型组(30例)与激惹型组(30例).所有病人采用超声引导下行外周神经脉冲射频.对两组病人术前、术后 1 周及 1、3、6 个月不同时间点的疼痛及睡眠质量进行评估,疼痛程度采用数字分级评分法(numerical rating scale,NRS)评分、睡眠质量采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评估,并对术后 6 个月时疗效进行评价.结果:与术前比较,两组病人NRS、PSQI评分在术后各时间点均降低(P<0.05).与混合型组比较,激惹型组病人术后 3 个月时NRS评分较低(P<0.05);术后 1 周、1、6 个月两组NRS评分差异无统计学意义.术后6个月时,混合型组有效率为93.3%,激惹型组有效率为70.0%(P<0.05).结论:脉冲射频能有效缓解带状疱疹后神经痛病人疼痛,两组中远期疗效无差异,但混合型组有效率更高.
Efficacy of pulsed radiofrequency in the treatment of provoked versus central reorganization post-herpetic neuralgia
Objective:To investigate the efficacy of pulsed radiofrequency in the treatment of provoked versus central reorganization postherpetic neuralgia.Methods:A total of 190 patients with postherpetic neuralgia admitted to the pain department of the Affiliated Hospital of Southwest Medical University from January 2020 to March 2023 were screened in the study.A total of 90 cases were enrolled according to the inclusion and exclusion criteria,and divided into a central reorganization group(30 cases in the central reorganization group)and an irritant group(30 cases in the irritant group)based on the propensity score matching.All patients were received the treatment of ultrasound-guided pulsed radiofrequency of peripheral nerves.The NRS scores and PSQI scores of PHN patients in both groups were evaluated at the time of pretreatment and 1 week postoperatively and 1,3,and 6 months follow-up,and the efficacy was evaluated at 6 months postoperatively.Results:NRS and PSQI scores were lower in both groups of patients at all postoperative time points compared with preoperative(P<0.05).Compared with the central reorganization group,patients in the irritant group had lower NRS scores at 3 months postoperatively(P<0.05)whereas the difference in NRS scores between the two groups was not statistically significant at 1 week postoperatively,1 and 6 months postoperatively.At 6 months postoperatively,there was no statistically significant efficacy difference between the two groups.However,the effective rate of the central reorganization group was 93.3%,and the effective rate of the irritant group was 70.0%(P<0.05).Conclusion:Pulsed radiofrequency is effective in relieving pain in patients with postherpetic neuralgia,and there is no difference in mid-and long-term efficacy between the two groups.However,the central reorganization group was more efficient.

postherpetic neuralgiapulsed radiofrequencyperipheral nerveirritable nociceptorcentral reorga-nization

李富波、龚格格、邱玲、欧册华

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西南医科大学附属医院 疼痛科,泸州 646000

西南医科大学附属医院 物理诊断科,泸州 646000

带状疱疹后神经痛 脉冲射频 周围神经 激惹型 混合型

四川省医学青年创新科研课题计划泸州市人民政府-西南医科大学科技战略合作项目

Q230992023LZXNYDJ018

2024

中国疼痛医学杂志
北京大学,中华医学会疼痛学分会

中国疼痛医学杂志

CSTPCD北大核心
影响因子:1.457
ISSN:1006-9852
年,卷(期):2024.30(8)