脉冲射频治疗急性期带状疱疹三叉神经痛疗效分析

EFFECT ANALYSIS OF PULSED RADIOFREQUENCY IN THE TREATMENT OF ACUTE HERPES ZOSTER TRIGEMINAL NEURALGIA

摘要:

目的：评价脉冲射频治疗急性期带状疱疹三叉神经痛的安全性和疗效。背景资料：带状疱疹三叉神经痛多发于老年人，发作时疼痛剧烈，说话、吃饭、刷牙等均可引发疼痛。虽然其所占比例较小，但常常合并角膜炎、失明、脑炎等严重的并发症，给患者生理心理带来极大的伤害，降低了患者生活质量。当前对于带状疱疹三叉神经痛的治疗有药物、皮内注射等方法，效果不佳，造成病程迁延，导致带状疱疹后神经痛（postherpetic neuralgia，PHN）发生率的升高，使患者长期饱受疼痛折磨。所以及时、有效的治疗可以缓解疼痛、减少并发症、降低PHN的发生。方法：采用脉冲射频治疗我院疼痛科处于急性期带状疱疹三叉神经痛患者11例，治疗后，对患者进行随访，并在患者出院时、术后1个月、3个月、6个月使用VSA评分评估患者治疗效果。结果：患者术前、出院时、术后1个月、3个月、6个月VAS分别为8.45±1.75分、2.45±1.13分、1.18±1.08分、0.18±0.40分、0分。出院时、术后1个月、3个月、6个月优良率分别为90.91%、100%、100%、100%。治疗后各时间段VAS分值明显低于术前（8.45±1.753），差异均具有统计学意义（P＜0.01），未出现严重的并发症。结论：脉冲射频治疗急性期带状疱疹三叉神经痛疗效显著；无明显的不良反应和并发症；可有效的避免PHN的形成。

Abstract:

Objective To evaluate the safety and efficacy of pulsed radiofrequency in the treatment of acute herpes zoster trigeminal neuralgia. Background data Herpes zoster trigeminal neuralgia is more common in the elderly, when the onset of severe pain, talking, eating, brushing teeth can cause pain. Although it accounts for a small proportion, it is often associated with keratitis, blindness, encephalitis and other serious complications, which bring great harm to patients' physiology and psychology and reduce their quality of life. Currently, the treatment of trigeminal neuralgia of herpes zoster includes drugs, intradermal injection and other methods, but the effect is not good, resulting in a prolonged course of disease, resulting in an increased incidence of post-zoster neuralgia (PHN), making patients suffer from pain for a long time. Therefore, timely and effective treatment can relieve pain, reduce complications and reduce the occurrence of PHN. Methods 11 patients with trigeminal neuralgia of herpes zoster at the acute stage in the pain department of our hospital were treated with pulsed radio frequency. After treatment, the patients were followed up, and the therapeutic effect of the patients was evaluated with VSA score at the time of discharge, 1 month, 3 months and 6 months after the surgery. Results VAS were 8.45±1.75 points, 2.45±1.13 points, 1.18±1.08 points, 0.18±0.40 points and 0 points at the time of discharge and 1, 3 and 6 months after surgery, respectively. The excellent and good rates were 90.91%, 100%, 100% and 100% at the time of discharge and 1, 3 and 6 months after the operation, respectively. VAS scores at each time period after treatment were significantly lower than those before surgery (8.45±1.753), the differences were statistically significant (P < 0.01), and no serious adverse reactions were observed. Conclusion Pulsed radiofrequency in the treatment of acute herpes zoster trigeminal neuralgia has a significant effect with low adverse reactions.