Force CT引导下双针脉冲射频治疗原发性舌咽神经痛疗效观察

THERAPEUTIC EFFECT OF DOUBLE-NEEDLE PULSED RADIOFREQUENCY GUIDED BY FORCE CT ON PRIMARY GLOSSOPHARYNGEAL NEURALGIA

摘要:

目的 对比观察Force CT引导下单针单极与双针单极脉冲射频治疗原发性舌咽神经痛的临床疗效。方法 收集2022年1月至2023年11月于包头市中心医院疼痛科就诊的原发性舌咽神经痛患者共20例,按治疗先后顺序以抛硬币法将患者随机分入对照组(n=10)及实验组(n=10),对照组接受单针单极脉冲射频治疗,实验组接受双针单极脉冲射频治疗。全部患者均于Force CT引导下将射频穿刺针穿刺至术前设计的治疗靶点,随后开始长时程脉冲射频治疗。观察记录两组患者CT扫描次数,治疗操作时间,术前及术后1、4、8、12周的巴罗神经病学研究所的疼痛程度(BNI-P)分级,疼痛数字评分(numerical rating scale, NRS),以及情绪评分(emotional scale, ES)和手术相关并发症发生情况。结果 对照组CT扫描次数［7.5(6,9)次］较实验组扫描次数［4(3,4.25)次］多,差异有统计学意义(Z =-3.82,P < 0.05)；对照组治疗操作时间［60(57.5,72.5)min］较实验组治疗操作时间［45(30,60)min］长,差异有统计学意义(Z =-2.64,P < 0.05)；首次治疗后对照组和实验组疗效有效率分别为［60%(6/10例)］和［80%(8/10例)］,差异无统计学意义(χ2 =0.63,P ＞0.05)。结论 实验组较对照组能减少CT扫描次数,降低患者受到的辐射量,缩短操作时间,提高手术效率。Force CT引导下双针脉冲射频治疗原发性舌咽神经痛效果与单针脉冲射频治疗效果差异不明显,但都具有一定治疗效果,且并发症不明显。

Abstract:

Objective Comparative observation of the clinical efficacy of single needle monopole and double needle monopole pulse radiofrequency therapy in the treatment of primary glossopharyngeal neuralgia under the guidance of Force CT.Methods A total of 20 patients with primary glossopharyngeal neuralgia who were treated in the pain department of Baotou Central Hospital from January 2022 to November 2023 were collected. The patients were randomly divided into a control group (n=10) and an experimental group (n=10) by coin tossing according to the order of treatment. The control group received single-needle unipolar pulse radiofrequency therapy, and the experimental group received double-needle unipolar pulse radiofrequency therapy. All patients were guided by Force CT to puncture the radiofrequency needle to the preoperative target, and then began long-term pulsed radiofrequency therapy. The number of CT scans, the time of treatment, the BNI-P grade before and at 1, 4, 8 and 12 weeks after operation, the numerical rating scale (NRS), as well as the emotional score(ES) and the incidence of surgical related complications were observed and recorded in the two groups.Results The number of CT scans in Contral group [7.5 (6,9)] was more than that in Experimental group [4 (3,4.25)], the difference was statistically significant (Z =-3.82, P < 0.05). The operation time of Contral group [60 (57.5, 72.5) min] was longer than that of Experimental group [45 (30, 60) min], the difference was statistically significant (Z =-2.64, P < 0.05). After the first treatment, the effective rates of Contral group and Experimental group were [60% (6 / 10 cases)] and [80% (8 / 10 cases)], respectively, the difference was not statistically significant (χ2 =0.63,P > 0.05). Conclusions Compared to the control group,the experimental group can reduce the number of CT scan, reduce the radiation dose, shorten the operation time and improve the operation efficiency. There is no significant difference in the therapeutic effect between the two needles guided by Force CT and the single needles in the treatment of glossopharyngeal neuralgia, but both have certain therapeutic effect and no obvious complications.