摘要
目的探讨CT引导下脊神经后根射频消融术治疗带状疱疹后神经痛(PHN)的疗效及安全性。方法回顾性纳入2017年1月至2020年4月于嘉兴学院附属医院疼痛科行CT引导下脊神经后根射频消融术治疗的PHN患者102例,年龄(69.7±9.4)岁,男42例,女60例。随访并记录患者术前(T_(0))及术后1 d(T_(1))、3个月(T_(2))、6个月(T_(3))、9个月(T_(4))和12个月(T_(5))时的疼痛数字评分法(NRS)评分、匹茨堡睡眠质量指数(PSQI)评分、满意度评分和并发症情况等。结果PHN患者在T_(0)、T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时间点的NRS评分M(Q_(1),Q_(3))分别为6(6,7)、2(2,3)、3(2,4)、3(2、4)、2(1,4)、2(1,4)分,PSQI评分M(Q_(1),Q_(3))分别为14(13,16)、4(3,6)、6(4,8)、5(4,6)、4(2,8)、4(2,9)分;与T_(0)相比,术后T_(1)~T_(5)各时间点的NRS和PSQI评分均降低,差异均有统计学意义(均P<0.001);患者术后1年总有效率为71.6%(73/102),满意度为8(5,9)分,复发率为14.7%(15/102),复发时间为(7.5±0.8)个月。术后主要并发症为麻木,发生率为86.0%(88/102),且随着时间的延长,麻木程度逐渐减轻。结论CT引导下脊神经后根射频消融术治疗PHN有效率较高,复发率较低,安全性较好,可能是治疗PHN的一种可行的手术方案。
Objective To investigate the efficacy and safety of CT-guided radiofrequency ablation of posterior root of spinal nerve in the treatment of postherpetic neuralgia(PHN).Methods A total of 102 PHN patients(42 males and 60 females)aged(69.7±9.4)years who underwent CT-guided radiofrequency ablation of posterior root of spinal nerve in the Department of Pain Medicine of the Affiliated Hospital of Jiaxing University from January 2017 to April 2020 were retrospectively included.Patients were followed up,and numerical rating scale(NRS)score,Pittsburgh sleep quality index(PSQI),satisfaction score and complications before surgery(T_(0))and at 1 d(T_(1)),3 months(T_(2)),6 months(T_(3)),9 months(T_(4))and 12 months(T_(5))after surgery were recorded.Results The NRS score of PHN patients at T_(0),T_(1),T_(2),T_(3),T_(4),and T_(5)[M(Q_(1),Q_(3))]was 6(6,7),2(2,3),3(2,4),3(2,4),2(1,4),2(1,4),respectively.Likewise,the PSQI score[M(Q_(1),Q_(3))]at aforementioned time points was 14(13,16),4(3,6),6(4,8),5(4,6),4(2,8),4(2,9),respectively.Compared with T_(0),the NRS and PSQI scores at all time points from T_(1)to T_(5)were lower,with statistically significant differences(all P<0.001).The overall effective rate of surgery at 1 year postoperatively was 71.6%(73/102)with a satisfaction score of 8(5,9),and the recurrence rate was 14.7%(15/102)with a recurrence time of(7.5±0.8)months.The main postoperative complication was numbness,with an incidence of 86.0%(88/102),and the degree of numbness gradually decreased with time.Conclusion CT-guided radiofrequency ablation of posterior root of spinal nerve for PHN has a high effective rate and a low recurrence rate,with high safety profile,and may be a feasible surgical option for the treatment of PHN.
作者
张志强
罗格
朱建军
倪华栋
黄兵
姚明
Zhang Zhiqiang;Luo Ge;Zhu Jianjun;Ni Huadong;Huang Bing;Yao Ming(Graduate School of Bengbu Medical College,Bengbu 233000,China;Department of Pain Medicine,the Affiliated Hospital of Jiaxing University,Jiaxing 314000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第7期483-487,共5页
National Medical Journal of China
基金
浙江省医药卫生科技计划(2019KY687)
浙江省省市共建重点学科‑疼痛医学(2019‑ss‑ttyx)
关键词
神经痛
带状疱疹后
射频消融
疗效
安全性
随访研究
Neuralgia,postherpetic
Radiofrequency ablation
Efficacy
Safety
Follow-up studies
