期刊文献+

脉冲射频与短时程脊髓电刺激治疗带状疱疹后神经痛的比较研究 被引量:20

COMPARISON OF PULSED RADIOFREQUENCY AND SPINAL CORD STIMULATION ON THE TREATMENT OF POSTHERPETIC NEURALGIA
下载PDF
导出
摘要 目的:观察脉冲射频与短时程脊髓电刺激治疗带状疱疹后神经痛(postherpetic neuralgia PHN)的疗效及相关炎性因子的变化。方法:纳入确诊PHN病人40例,按数字随机表分为短时程脊髓电刺激组(A组,n=20)与脉冲射频术组(B组,n=20),观察治疗前后不同时点:术前、治疗后3天、10天、1月、2月、3月的治疗效果及相关炎性因子变化,记录两组病人并发症(气胸、穿刺部位血肿、神经损伤)及卫生经济学指标(手术时间、手术费用、药费、化验检查费、住院总费用及住院天数)。结果:两组病人治疗后简化麦吉尔评分及视觉模拟评分均降低(P <0.05),睡眠质量评分较治疗前显著增加(P <0.01);两组间差异无统计学意义(P> 0.05);治疗后肿瘤坏死因子(tumor necrosis factor TNF) TNF-α、白介素(interleukin IL) IL-1β均低于治疗前(P <0.05);IL-8治疗前后变化差异无统计学意义(P> 0.05)。射频治疗组并发症发生率、手术时间、药费明显高于短时程脊髓电刺激组(P <0.05),手术费用、住院总费用、住院天数明显低于短时程脊髓电刺激组(P <0.05)。结论:两种介入手术均可有效缓解PHN病人临床症状,相关疼痛因子水平均较治疗前降低,射频治疗组不良反应发生率较高。 Objective: To investigate the ef?cacy of the spinal cord stimulation and pulsed radiofrequency on treatment of postherpetic neuralgia(PHN). Methods: Forty patients with PHN were divided into spinal cord stimulation group(SCS, A group, n = 20) and pulsed radiofrequency group(B group, n = 20). The short-form Mc Gill pain questionnaire(SF-MPQ) and sleep quality scores were used for evaluation of pain degree and sleep quality before treatment(T0)and at different time points after treatment(T1: 3 days later,T2: 10 days later, T3: 1 st month, T4: 2 nd month and T5: 3 rd month). Side effects(pneumothorax, hematoma, nerve injury) and medical economic parameters(time of operation, cost of operation, cost of drugs, cost of examinations, total costs, time of hospital stay) were recorded. Results: Compared with T0, the SF-MPQ and visual analogue scale(VAS) score of 2 groups were signi?cantly decreased at different time points after treatment(P < 0.01), and the sleep quality scores were signi?cantly increased at different time points(P < 0.01). Compared with T0, the levels of serum TNF-α and IL-1β were reduced after treatment;IL-8 were not changed compared with pre-operation. Side effect rates, time of operations and cost of drugs of B group were signi?cantly higher than those of A group, cost of operation, total cost, time of hospital stay were markedly reduced than A group. Conclusion: The spinal cord stimulation and pulsed radiofrequency can signi?cantly alleviate postherpetic neuralgia pain and enhance quality of sleep. Pulsed radiofrequency treatment has a higher side effect rates.
作者 王蕊 孙明洁 于洋 陈付强 WANG Rui;SUN Ming-Jie;YU Yang;CHEN Fu-Qiang(Department of Pain Management/medicine,Qingdao Municipal Hospital,Qingdao Pain Clinical Research and Treatment Center,Qingdao,266011,China)
出处 《中国疼痛医学杂志》 CAS CSCD 北大核心 2019年第11期831-836,共6页 Chinese Journal of Pain Medicine
基金 青岛市市立医院(集团)“总院长新技术、新项目创新研究基金”
关键词 短时程脊髓电刺激 脉冲射频 炎性因子 带状疱疹后神经痛 Spinal cord stimulation Pulsed radiofrequency Inflammatory factor Postherpetic neuralgia
  • 相关文献

参考文献5

二级参考文献58

  • 1谭宪湖,谭冠先,何睿林,秦科.神经阻滞联合药物治疗老年胸背部带状疱疹后神经痛的临床观察[J].临床麻醉学杂志,2005,21(1):33-35. 被引量:17
  • 2陈大伟,谢鹏,邹德智,徐平.带状疱疹后遗神经痛患者血清IL-6水平与神经损伤的关系[J].中国神经免疫学和神经病学杂志,2005,12(3):140-142. 被引量:30
  • 3WU CL,Marsh A,Dworkin RH.The role of sympathetic nerves in her-pes zoster and postherpetic neuralgia[J].Pain 2000,87(Suppl):121-129.
  • 4张学军皮肤性病学[M]北京:人民卫生出版社,2008:63-64.
  • 5Johnson R.herpes zoster-predicting and minimizing the impact ofpost-herpetic neuralgia[J].Antimicrob Chemother.2001,47(Sup-pl):1:1-8.
  • 6Bennett GJ.Hypotheses on the pathogenesis of herpes zoster associatedpain[J].Ann Neurol,1994,35(suppl):s38-s41.
  • 7Shamash S,Reichert F,Rotshenker S.The cytokine network of walleri-an degeneration:tumor necrosis factor-alpha,Interleukin-lalpha,and Interleukin-l beta[J].Neurosci,2002,22(8):3052-60.
  • 8Kotani N,Kudo R Sakurai Y,et al.Cerebrospinal fluid interleukin 8concentrations and the subsequent development of postherpetic neural-gia.Am[J].Med,2004,116(5):318-24.
  • 9Xiao-chun Jin,Robert W,Gereau IV.Acute p38-Mediated Modu-lation of Tetrodotoxin-Resistant Sodium Channels in Mouse SensoryNeurons by Tumor Necrosis Factor-α[J].The Journal of Neuro-science,2006,26:246-255.
  • 10Zelenka M,Schafers M,Sommer C.Intraneural injection of interleukin-1beta and tumor necrosis factor-alpha into rat sciatic nerve atphysiological doses induces signs of neuropathic pain[J].Pain,2005,116:257-263.

共引文献94

同被引文献142

引证文献20

二级引证文献88

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部