奇神经节联合骶神经脉冲射频治疗会阴痛的疗效分析

Add ganglion combined with sacral nerve pulsed radiofrequency in perineal pain, analysis of treatment effect.

摘要:

目的 会阴痛作为一种特殊部位、原因复杂的慢性疼痛，其诊疗方法一直在不断探索改进。以往术式选择多为奇神经节化学毁损或热凝毁损术，此术式造成腔组织器官损伤风险较高。本文目的为探究奇神经节联合骶神经脉冲射频治疗会阴痛的疗效。方法 选择保守治疗3个月以上无效的会阴痛患者共15例，治疗方法为奇神经节脉冲射频+骶神经脉冲射频，术后随访观察1d、1w、1m、6m的疗效和并发症，进行数据分析。结果 术后1d、1w、1m、6m与术前相比疼痛数字评分（NRS）、匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index, PSQI）和汉密尔顿抑郁量表-17（Hamilton Depression Scale, HAMD-17）均显著降低（P＜0.001），且无并发症发生。但随时间延长，NRS评分、PSQI评分和HAMD-17评分会随之增加。 结论 奇神经节脉冲射频术联合骶神经脉冲射频术治疗会阴部疼痛有显著效果，安全且无明显并发症发生。随着时间延长，疼痛程度也会逐渐加重，但是仍较术前改善明显。

Abstract:

Objective: Perineal pain is a kind of chronic pain occurred in a special body location due to complex causes. Its diagnosis and treatment methods have been continuously explored and improved. In the past, most of the surgical options were chemical damage or thermal coagulation damage to the odd ganglion, which caused a higher risk of damage to luminal tissues and organs. The paper aims to explore the effect of the odd ganglion combined with sacral nerve pulsed radiofrequency in the treatment of perineal pain. Method: A total of 15 patients with perineal pain who opted for and experienced the conservative treatment for more than 3 months which, however, proved to be a failure were selected. The treatment method was odd ganglion pulsed radiofrequency plus sacral nerve pulsed radiofrequency. The treatment effect and possible complications were observed respectively for 1 day, 1 week, 1 month, and 6 months after surgery, followed by data analysis. Results: The NRS score, PSQI score and HAMD-17 score were significantly lower for 1 day, 1 week, 1 month, and 6 months after surgery compared with both types of scores before surgery (P<0.01) with no complications occurred. However, the NRS score, PSQI score and HAMD-17 score increase with time. Conclusion: Odd ganglion pulsed radiofrequency surgery combined with sacral nerve pulsed radiofrequency surgery has a significant effect on the treatment of perineal pain, which is safe and has no obvious complications. Over time, the effect of surgery on pain treatment will gradually decrease but still has significantly improved from the situation before surgery.