超声引导下胸椎间孔神经阻滞治疗胸背部PHN的临床观察

Clinical observation of ultrasound-guided thoracic intervertebral foraminal nerve block for treatment of thoracic and back PHN

摘要:

目的：观察和分析超声引导下胸椎间孔神经阻滞治疗胸背部带状疱疹后神经痛(postherpetic neuralgia,PHN)的临床效果和安全性。方法：40例胸背部PHN住院患者随机分为二组,每组20例：观察组(A组)-在给予普瑞巴林和神经妥乐平治疗的基础上,根据受累胸脊神经实施相应胸椎间孔神经阻滞治疗；对照组(B组)-在给予普瑞巴林和神经妥乐平治疗的基础上,实施疼痛相应区域皮内注射阻滞治疗。治疗前及疗程完成后第3天、3月和12月进行疼痛程度及安全性评估 。结果：疗程完成后第3天,与治疗前比较,两组VAS评分均减少,差异有统计学意义(P<0.05)；两组间比较,A组VAS评分减少数高于B组,差异有统计学意义(P<0.05)。疗程完成后3月,A组有效率75％,B组有效率55％,其间有统计学差异(P<0.05)。疗程完成后12月,A组有效率80％,B组有效率60％,其间有统计学差异(P<0.05)。各例治疗过程中均无严重不良反应发生。结论：超声引导下胸椎间孔神经阻滞术是治疗胸背部PHN安全有效的方法,其总体疗效高于皮内注射阻滞治疗。

Abstract:

Objective:To observe and analyze the clinical effect and safety of ultrasound-guided thoracic intervertebral foraminal nerve block in the treatment of postherpetic neuralgia (PHN).Methods:Forty patients with PHN in chest and back were randomly divided into two groups, 20 in each group:observation group (group A)-based on the treatment of pregabalin and neurotropin,the corresponding thoracic intervertebral foraminal nerve block were implemented according to the affected thoracic spinal nerves;control group (group B)-based on pregabalin and neurotropin treatment,intradermal nerve block treatment was performed in the corresponding area of ??pain.The degree of pain and safety were evaluated before treatment and on the third day, third month,and twelveth month after the completion of the course.Results:On the third day after the completion of the treatment,compared with before treatment,the VAS scores of the two groups were reduced,and the difference was statistically significant (P<0.05);compared between the two groups,the reduction of the VAS scores of the A group was higher than that of the B group,and the difference was statistical significance (P<0.05).Three months after the completion of the course of treatment,the effective rate in group A was 75% and the effective rate in group B was 55%,with a statistical difference (P<0.05).12 months after the completion of the course of treatment,the effective rate of group A was 80%,and the effective rate of group B was 60%, with a statistical difference (P<0.05).No serious adverse reactions occurred during the treatment of each case.Conclusion:Ultrasound-guided thoracic intervertebral foraminal nerve block is a safe and effective method for treating PHN in the chest and back,and its overall effect is higher than that of intradermal nerve block.