短时程背根神经电刺激与脊髓电刺激治疗疱疹性神经痛的疗效分析

THE ANALYSIS OF THE OUTCOMES FOR PATIENTS WITH ZOSTER-RELATED NEURALGIA BETWEEN THE TREATMENT OF TEMPORARY DORSAL NERVE ROOT STIMULATION AND THE TEMPORARY SPINAL CORD STIMULATION

摘要:

目的：对治疗带状疱疹性神经痛的短时程背根神经电刺激与脊髓电刺激两种方法的手术时间、放射暴露剂量、疗效及花费进行比较。方法：本文采用回顾性分析方法，对202例在DSA引导下使用短时程电刺激治疗的带状疱疹性神经痛患者（其中64例采用背根神经电刺激，138例采用脊髓电刺激），记录手术操作时间及每一手术的辐射剂量，术后患者的程控次数，术前及术后，术后1，2，3月等各时间段对患者的疼痛程度，生活质量以及医疗耗材费等信息进行分析比较。结果：在3个月的随访期间，所有病人在两种方法治疗后疼痛评分和生活质量评分均有明显下降（P<0.01），但两种方法之间没有差别，然而背根神经电刺激患者的手术时间和术中辐射量明显少于脊髓电刺激组（P<0.05）；而且术后平均程控次数以及医疗耗材费用也明显少于脊髓电刺激组（P<0.05）。结论：短时程的背根神经电刺激和脊髓电刺激都能有效治疗带状疱疹性神经痛，但背根神经电刺激具有程控次数少，覆盖好，花费少等优点。

Abstract:

Objective: To compare the procedure time, radiation doses, effectiveness and the cost for patients with zoster-related neuralgia (ZRN) between the treatment of the temporary dorsal nerve root stimulation(tDNRS) and the temporary spinal cord stimulation(tSCS) .Methods: In this retrospective analysis, a total of 202 patients with ZRN were treated with tDNRS(n=64) and tSCS(n=138) under the guidance of digital subtraction angiography(DSA).The procedure time, radiation doses, the number of modulation for postoperative patients, the visual analog scale(VAS),the quality of life and the cost of medical equipment were recorded and analyzed at the time before procedure, after stimulation, and 1,2 and 3 months’follow-up. Results:The average scale of VAS and the quality of life for all patients who treated with tDNRS or tSCS decreased significantly at the time of post stimulation and 1,2,3 months’ follow-up compared with the scores before procedure(P<0.01), there is no difference between the two groups. However, the procedure time and the radiation doses in patients with tDNRS were significantly less than those with tSCS(P<0.05), and the numbers of modulation and the cost of medical equipment in patients with tDNRS were significantly less than those with tSCS(P<0.05). Conclusions: Both tDNRS and tSCS can effectively reduce the pain of ZRN patients, however, the ZRN patients could get more benefits from tDNRS.