富血小板联合肩胛上神经脉冲射频治疗急性带状疱疹合并慢性肩周炎的临床研究

Clinical observation of autologous platelet-rich plasma combined with suprascapular nerve pulse radiofrequency in the treatment of acute herpes zoster complicated with chronic scapulohumeral periarthritis

摘要:

目的：探讨自体富血小板血浆 (platelet-rich plasma, PRP) 联合超声引导肩胛上神经脉冲射频(pulse radiofrequency, PRF) 治疗急性带状疱疹合并慢性肩周炎的临床疗效。 方法：回顾性分析2020年5月～2022年5月期间在我科治疗急性带状疱疹合并慢性肩周炎52例病人,单独行超声引导PRF治疗患者为对照组(D组),PRP联合超声引导PRF治疗患者为实验组(F组)。收集病人一般资料、临床疗效、并发症发生率。临床疗效包括疼痛评分(visual analogue scale, VAS评分)、肩关节功能评分(Constant-Murley, CMC)和加巴喷丁使用量等指标。 结果：术后两组患者病情均得到明显缓解(P＜0.05,vs术前),总体F组效果更佳。术后18d后VAS评分低和CMC评分增高(F组 vs D组,P＜0.05)；加巴喷丁使用量和带状疱疹后遗神经痛发生率降低(F组 vs D组, P＜0.05)。结论：PRP联合超声引导肩胛上神经脉冲射频治疗急性带状疱疹疼痛合并慢性肩周炎疗效优于单独超声引导脉冲射频,是一种安全有效的联合疗法。

Abstract:

Objective: To investigate the clinical efficacy of autologous platelet-rich plasma (PRP) combined with ultrasound-guided suprascapular nerve pulse radiofrequency (PRF) in the treatment of acute herpes zoster complicated with chronic scapulohumeral periarthritis. Methods: From May 2020 to May 2022, 52 patients with acute herpes zoster combined with chronic scapulohumeral periarthritis in our department were observed and analyzed. The patients who received ultrasound-guided PRF treatment alone were the control group (group D), and the patients were treated with PRP combined with ultrasound. The patients treated with PRF were guided to be the experimental group (group F). The general information, clinical efficacy and complication rate of the patients were collected. Clinical efficacy included pain score (visual analogue scale, VAS score), shoulder joint function score (Constant-Murley, CMC) and gabapentin usage and other indicators. Results: The condition of the patients in both groups was significantly relieved after operation (P<0.05, vs before operation), and the overall effect of group F was better. The VAS score was low and the CMC score was increased 18 days after the operation (group F vs group D, P<0.05); the dosage of gabapentin and the incidence of postherpetic neuralgia were decreased (group F vs group D, P<0.05). Conclusion: The efficacy of PRP combined with ultrasound-guided suprascapular nerve pulsed radiofrequency in the treatment of acute herpes zoster pain complicated with chronic scapulohumeral periarthritis is better than that of ultrasound-guided pulsed radiofrequency alone, and it is a safe and effective combination therapy.